Impact of Polygenic Risk Scoring for Coronary Artery Disease on the Incidence of Chronic Kidney Disease and Acute Kidney Injury in Patients Undergoing Off Pump Coronary Artery Bypass Surgery

Background: This study aims to determine the applicability of genome-wide polygenic risk score (GPS CAD ) to patients who underwent off-pump (OP-CABG) in South-Asian population and influence, on kidney dysfunction and incidence of AKI in OP-CABG. Methods: Study participants were categorized into four cohorts: 1) patients with normal renal function undergoing OP-CABG (eGFR>60ml/min/m 2 ) (n=754; AKI - 81, Non-AKI-673); 2)patients with renal dysfunction (eGFR<60ml/min/m 2 ; not needing dialysis) undergoing OP-CABG (n=263; AKI-169, non-AKI-89); 3) patients with renal dysfunction with no symptomatic/known heart disease (n=92);4) control population (with normal kidney function, without symptomatic/known heart disease) (n=826). Genotyping was performed using Infinium Global Screening Array-24 v3.0 BeadChip from Illumina, which included 6,54,027 markers. The genotype data were imputed using the GenomeAsia reference panel and GPS CAD was determined. The GPS CAD was applied to all patients in the cohort. The following were determined (i) relationship between GPS CAD and CAD (ii) association between GPS CAD and incidence of preoperative renal dysfunction (iii) influence of GPS CAD on development of postoperative AKI and (iv) influence of a composite genetic predisposition to AKI in OP-CABG and GPS CAD on the surgical outcome. Results: The GPS CAD was generated for all samples in the four groups and was binned into 10 groups (deciles), in the ascending order of GPS CAD. The first decile (lowest GPS CAD bin) comprised ~60% of healthy controls, and 22% group A, 11% group B, and 7 % group C. . No difference was observed in GPS CAD between AKI and non-AKI samples belonging to group A. Conclusions: In summary, our results suggest no impact of GPS CAD on the presence of kidney dysfunction and incidence of AKI after off-pump CABG.