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Updated: Mar 25, 2026

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Economic modeling of polygenic risk prediction of coronary artery disease in childhood

Fouad Bitar1,2, Rana Zareef3, Hussain Ismaeel4

  • 1Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA.

NPJ Cardiovascular Health
|March 24, 2026
PubMed

Insights

Polygenic risk scores (PRS) can identify children at high lifetime risk for coronary artery disease (CAD). PRS-guided prevention strategies offer significant cost savings and reduce CAD events by targeting high-risk individuals early.

Area of Science:

  • Cardiovascular Disease Research
  • Genetics and Genomics
  • Preventive Medicine

Background:

  • Coronary artery disease (CAD) risk factors and subclinical pathophysiology originate in childhood.
  • Identifying children for primordial prevention of CAD is challenging.
  • Polygenic risk scores (PRS) offer a DNA-based risk marker from birth for stratifying lifetime CAD risk in children.

Purpose of the Study:

  • To evaluate the clinical utility and cost-effectiveness of PRS-guided CAD prevention in children.
  • To assess the impact of PRS-guided interventions on CAD event reduction and healthcare costs.

Main Methods:

  • A Markov model was employed to compare PRS-guided prevention with standard prevention.
  • The model simulated a hypothetical cohort of 10,000 children.
  • Children in the top 20% of PRS distribution (n=2000) were assumed to receive behavioral interventions.

Main Results:

  • PRS-guided prevention was projected to prevent 72 CAD events among 2000 high-risk children.
  • This represents a 3.6% absolute reduction in CAD events.
  • The intervention demonstrated a significant return on investment of 3614%.

Conclusions:

  • Polygenic risk scores enable early and targeted prevention of CAD in children.
  • PRS-guided prevention strategies improve health outcomes.
  • Implementing PRS-guided prevention is cost-effective, lowering lifetime healthcare costs.

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