More than 60 genetic risk variants predisposing to coronary artery disease (CAD) have been confirmed. The genetic risk for CAD is related to the number of genetic risk variants present and can be expressed as a genetic risk score (GRS), by summing the product of the number of high-risk variants inherited by each individual times the log of the odds ratio. Studies show risk stratification for CAD, based on the GRS, is more discriminatory than conventional risk factors and predicts the response to statin therapy. A prospective trial showed individuals with high GRS had 91% greater risk of cardiac events, and individuals with a healthy lifestyle had 46% fewer cardiac events than an unfavorable lifestyle. GRS remains the same throughout one's lifetime because your deoxyribonucleic acid does not change. GRS, determined as early as birth from saliva, is inexpensive and could transform the prevention of CAD in low- and middle-income countries.

Highlights

• Over 60 genetic variants predisposing to CAD have been discovered and confirmed in independent populations.
• GRS determined from genetic risk factors for CAD more accurately stratifies for risk than conventional risk factors do.
• GRS for CAD can be determined at birth or any time thereafter because one’s DNA does not change in one’s lifetime.
• Using the GRS for CAD, a clinical trial was performed based on stratification by the GRS that showed a healthy lifestyle, compared with an unfavorable lifestyle, was associated with a 46% reduction in cardiac events.
• GRS, determined from a saliva sample, is convenient, inexpensive, and could transform primary and secondary prevention of CAD in low- and middle-income individuals.