Prevention & lipidsCohort study

Predictive Accuracy of a Polygenic Risk Score–Enhanced Prediction Model vs a Clinical Risk Score for Coronary Artery Disease

JAMAPublished

  • Cohort study
  • UK Biobank
  • case-control sample for score optimisation
  • separate cohort for evaluation

Authors' conclusion

The addition of a polygenic risk score for CAD to pooled cohort equations was associated with a statistically significant, yet modest, improvement in the predictive accuracy for incident CAD and improved risk stratification for only a small proportion of individuals.

Study context

Population
UK Biobank participants enrolled 2006–20106,272 incident coronary artery disease (CAD) events
Participants
352,660 participants
Exposure
PRS-enhanced model vs pooled cohort equations for CAD risk prediction
Outcome
Incident CAD (MI and its related sequelae): discrimination, calibration and reclassification (risk threshold 7.5%)
Follow-up
Median 8 years

Main finding

Incident CAD

Overall net reclassification improvement

4.0%

95% CI 3.1%–4.9%

By group

Polygenic risk score

0.61

C statistic · 95% CI 0.60–0.62

Pooled cohort equations

0.76

C statistic · 95% CI 0.75–0.77

Both combined

0.78

C statistic · 95% CI 0.77–0.79

As reported in the abstract

Observational data: associations, not effects.

Original publication

Predictive Accuracy of a Polygenic Risk Score–Enhanced Prediction Model vs a Clinical Risk Score for Coronary Artery Disease. JAMA. Published 18 February 2020. doi:10.1001/jama.2019.22241

Summarised from the published abstract; every number is checked against it