Coronary artery disease (CAD) is a complex disease caused by a combination of genetic, environmental and lifestyle factors. Identifying individuals who are at high risk of developing CAD is crucial in planning timely preventive treatment. Although heritable factors account for 40–60% of development of the disease, currently used risk scores do not take genetic factors into account.
Recent developments in genetics have led to the discovery of more than 50 genetic risk variants associated with CAD. Combining markers into polygenic risk score would help to identify patients who are at the highest risk for developing myocardial infarction and who would achieve the greatest benefit from preventive therapy.
A more detailed understanding of the human genome and the genetic architecture of CAD would pave the way for incorporation of genetic risk factors in clinical practice. We are of the opinion that comprehensive management of CAD will require evaluation of conventional as well as genetic risk factors in the near future.