Researchers have now found that a polygenic risk score (PRS), derived from genetic markers, can enhance the prediction of incident HF in AF patients, particularly among younger individuals.

Using data from the UK Biobank, the study analyzed 21,167 White Caucasian participants with newly diagnosed AF and no prior history of HF. Participants were categorized into low- and moderate-to-high PRS groups and followed for a median of 3.8 years. Overall, the incidence of HF was 29.9 per 1000 patient-years. The findings of the study were reported in Europace. 

Patients with a moderate-high PRS had a higher risk of developing HF compared with those with low PRS [adjusted hazard ratio (HR) 1.18, 95% CI 1.05–1.32]. The effect was most in younger AF patients (<60 years), where moderate-high PRS more than doubled the risk [HR 2.14, 95% CI 1.29–3.57], compared to only a modest increase in older patients [HR 1.13, 95% CI 1.01–1.27]. 

HF developed earlier in younger AF patients with moderate to high PRS (median 1.5 years vs. 4.2 years in those with low PRS). Adding PRS to conventional clinical risk factors improved the prediction and reclassification of HF risk, with a 29.7% improvement in reclassification for younger patients.