A Breakthrough in Genetics and its Relevance to Prevention of Coronary Artery Disease in LMIC

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.