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. 2022 Dec 15;2(6):oeac079.
doi: 10.1093/ehjopen/oeac079. eCollection 2022 Nov.

Effectiveness and feasibility of cardiovascular disease personalized prevention on high polygenic risk score subjects: a randomized controlled pilot study

Margus Viigimaa  1   2 , Mikk Jürisson  3 , Heti Pisarev  3 , Ruth Kalda  3 , Helene Alavere  4 , Alar Irs  5 , Aet Saar  2   6 , Krista Fischer  4   7 , Kristi Läll  4 , Krista Kruuv-Käo  4 , Nina Mars  8 , Elisabeth Widen  8 , Samuli Ripatti  8 , Andres Metspalu  4
Affiliations

Effectiveness and feasibility of cardiovascular disease personalized prevention on high polygenic risk score subjects: a randomized controlled pilot study

Margus Viigimaa et al. Eur Heart J Open. .

Abstract

Aims: The aim of this study was to evaluate the effect of the intervention by proactively sharing a patient's high polygenic risk score (PRS) for coronary artery disease (CAD). Outcomes included: (i) reduction in cardiovascular disease (CVD) risk factors over 12 months; (ii) difference in purchased prescriptions of lipid-lowering and anti-hypertensive drugs between intervention group and control group subjects; and (iii) opinion of the participating physicians and subjects on PRS usefulness.

Methods and results: This randomized controlled trial was conducted among middle-aged subjects with a top 20% CAD PRS in a family medicine setting. Participants were selected from 26 953 Estonian Biobank cohort participants. Subjects were informed and counselled about their PRS score and CAD risk using the visual tool at baseline (Visit I), counselling session (Visit II), and on the final Visit III at 12 months. The primary endpoint was not significantly different. However, the intervention group participants had a significantly higher probability of initiating statin treatment compared with the controls. Their levels of LDL-cholesterol (LDL-C) were significantly decreased compared with baseline on Visit III and significantly lower than in the control group. The vast majority of participating family physicians believe that finding out about genetic risks will affect the subject's lifestyle and medication compliance.

Conclusion: Most of our outcome measures were in favour of this intervention. Participants achieved larger changes in cholesterol and blood pressure values. The vast majority (98.4%) of family physicians are interested in continuing to use genetic risk assessment in practice.

Keywords: Polygenic risk score; coronary artery disease; personalized prevention.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Responses to the physician feedback questionnaire.
See this image and copyright information in PMC

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