Model Including Polygenic Risk, Polysocial Score Improves CHD Risk Prediction
THURSDAY, Dec. 12, 2024 -- A prediction model incorporating a polygenic risk score (PRS) and polysocial score (PSS), including social determinants of health and lifestyle-psychological factors, improves performance of clinical risk calculators for coronary heart disease (CHD), according to a study published online Dec. 10 in the Annals of Internal Medicine.
Mohammadreza Naderian, M.D., M.P.H., from the Mayo Clinic in Rochester, Minnesota, and colleagues developed and evaluated a prediction model that incorporated a PRS and PSS to improve CHD risk prediction among U.K. Biobank participants recruited from 2006 to 2010.
The researchers found that the hazard ratios were 1.43 and 1.59 for one standard deviation increase in PSSCHD and PRSCHD, respectively, among 388,224 participants. Compared with White persons, non-White persons had higher PSSCHD. Both independent and additive effects were seen for PSSCHD and PRSCHD on CHD. Overall, 12 percent of participants were reclassified at a 10-year CHD risk threshold of 7.5 percent by adding PSSCHD and PRSCHD to pooled cohort equations (PCE), with the risk for CHD 1.86 times higher in the up- versus down-reclassified persons; superior performance was observed compared with PCE as reflected by improved net benefit while maintaining good calibration relative to the clinical risk calculators. When incorporating PSSCHD and PRSCHD into Predicting Risk of cardiovascular disease EVENTs and QRISK3 measures, the results were similar.
"Our findings support the integration of PRS, social determinants of health, and lifestyle-psychological factors in CHD risk equations and have implications for measures at the population level to reduce the burden of CHD as well as at the individual level to improve risk prediction of CHD," the authors write.
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