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                  <mods:namePart>NIH - National Heart, Lung, and Blood Institute (NHLBI) (Estados Unidos)</mods:namePart>
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                  <mods:namePart>Medical Research Council (Reino Unido)</mods:namePart>
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                  <mods:dateAccessioned encoding="iso8601">2020-06-10T07:11:49Z</mods:dateAccessioned>
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                  <mods:dateIssued encoding="iso8601">2020-04-21</mods:dateIssued>
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               <mods:identifier type="citation">J Am Heart Assoc. 2020; 9(8):e015299</mods:identifier>
               <mods:identifier type="doi">10.1161/JAHA.119.015299</mods:identifier>
               <mods:identifier type="e-issn">2047-9980</mods:identifier>
               <mods:identifier type="journal">Journal of the American Heart Association</mods:identifier>
               <mods:identifier type="pubmedID">32308120</mods:identifier>
               <mods:identifier type="uri">http://hdl.handle.net/20.500.12105/10316</mods:identifier>
               <mods:abstract>Background Epigenome-wide association studies for cardiometabolic risk factors have discovered multiple loci associated with incident cardiovascular disease (CVD). However, few studies have sought to directly optimize a predictor of CVD risk. Furthermore, it is challenging to train multivariate models across multiple studies in the presence of study- or batch effects. Methods and Results Here, we analyzed existing DNA methylation data collected using the Illumina HumanMethylation450 microarray to create a predictor of CVD risk across 3 cohorts: Women's Health Initiative, Framingham Heart Study Offspring Cohort, and Lothian Birth Cohorts. We trained Cox proportional hazards-based elastic net regressions for incident CVD separately in each cohort and used a recently introduced cross-study learning approach to integrate these individual scores into an ensemble predictor. The methylation-based risk score was associated with CVD time-to-event in a held-out fraction of the Framingham data set (hazard ratio per SD=1.28, 95% CI, 1.10-1.50) and predicted myocardial infarction status in the independent REGICOR (Girona Heart Registry) data set (odds ratio per SD=2.14, 95% CI, 1.58-2.89). These associations remained after adjustment for traditional cardiovascular risk factors and were similar to those from elastic net models trained on a directly merged data set. Additionally, we investigated interactions between the methylation-based risk score and both genetic and biochemical CVD risk, showing preliminary evidence of an enhanced performance in those with less traditional risk factor elevation. Conclusions This investigation provides proof-of-concept for a genome-wide, CVD-specific epigenomic risk score and suggests that DNA methylation data may enable the discovery of high-risk individuals who would be missed by alternative risk metrics.</mods:abstract>
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                  <mods:title>Epigenomic Assessment of Cardiovascular Disease Risk and Interactions With Traditional Risk Metrics.</mods:title>
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