Response to Polygenic Risk: Results of the MyGeneRank Mobile Application-Based Coronary Artery Disease Study
Evan D. MuseiD, Shang‐Fu CheniD, Shuchen LiuiD, Brianna Fernandez, Brian Schrader, Bhuvan Molparia, André Nicolás LeóniD, Raymond Lee, Neha Pubbi, Nolan Mejia, Christina Ren, Ahmed El-kallinyiD, Ernesto Prado Montes deiD, Hector E. Tamez, Arjun Ghoshal, Raquel DiasiD, Doug Evans, Kaiyu CheniD, Yunyue ZhangiD, Nathan E. WineingeriD, Emily G. SpenceriD, Eric J. TopoliD, Ali TorkamaniiD
Abstract
The degree to which polygenic risk scores (PRS) influence preventive health is the subject of debate, with few prospective studies completed to date. We developed a smartphone application for the prospective and automated generation, communication, and electronic capture of response to a PRS for coronary artery disease (CAD). We evaluated self-reported actions taken in response to personal CAD PRS information, with special interest in the initiation of lipid lowering therapy (NCT03277365). 20% of high genetic risk (n=95) vs 7.9% of low genetic risk individuals (n=101) initiated lipid lowering therapy at follow-up (p-value = 0.002). The initiation of both statin and non-statin lipid lowering therapy was associated with degree of genetic risk - 15.2% (n=92) vs 6.0% (n=100) for statins (p-value = 0.018) and 6.8% (n=118) vs 1.6% (n=123) for non-statins (p-value = 0.022) in high vs low genetic risk, respectively. Overall, degree of genetic risk was associated with use of any lipid lowering therapy at follow-up - 42.4% (n=132) vs 28.5% (n=130) (p-value = 0.009). We also find that CAD PRS information is perceived to be understandable, actionable, and does not induce health anxiety.
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