BACKGROUND: Clinical risk calculators for coronary heart disease (CHD) do not include genetic, social, and lifestyle-psychological risk factors. OBJECTIVE: To improve CHD risk prediction by developing and evaluating a prediction model that incorporated a polygenic risk score (PRS) and a polysocial score (PSS), the latter including social determinants of health and lifestyle-psychological factors. DESIGN: Cohort study. SETTING: United Kingdom. PARTICIPANTS: UK Biobank participants recruited between 2006 and 2010. MEASUREMENTS: Incident CHD (myocardial infarction and/or coronary revascularization)
10-year clinical risk based on pooled cohort equations (PCE), Predicting Risk of cardiovascular disease EVENTs (PREVENT), and QRISK3
PRS (Polygenic Score Catalog identification: PGS000028) for CHD (PRS RESULTS: In 388 224 participants (age, 55.5 [SD, 8.1] years
42.5% men
94.9% White), the hazard ratio for 1 SD increase in PSS LIMITATION: A predominantly White cohort
possible healthy participant effect and ecological fallacy. CONCLUSION: A PSS PRIMARY FUNDING SOURCE: National Human Genome Research Institute.