Genetics provides approximately a 50% risk contribution to the development of coronary heart disease and related major adverse cardiovascular events, e.g. myocardial infarction or heart attack (Zdravkovic et al., 2002; Wienke et al., 2005; Elosua et al., 2009; Roberts R, 2018). As a result, genetics is now recognised as a vitally important risk factor to be included in the patient risk assessment of coronary heart disease.

There is a direct and linear relationship between genetic load and the risk of a coronary event, both the incidence of the event and recurrence (Lluis-Ganella et al., 2010; Lluis-Ganella et al., 2012; Mega et al., 2015; Natarajan et al., 2017; Rincón et al., 2020; Marston et al., 2020; Damask et al., 2020; Emdin et al., 2020).

A significant proportion of cardiovascular events take place in individuals clinically classified in low or intermediate risk groups based on traditional (non-genetic) cardiovascular risk factors (Marrugat et al., 2011; Iribarren et al., 2016).

Genetic risk assessment in addition to clinical risk provides a comprehensive cardiovascular lifetime risk assessment to identify patients at the highest overall risk of coronary heart disease. The combination of genetic and clinical risk enables a ‘personalised medicine’ approach to preventing cardiovascular disease through lifestyle change, treatment therapy and/or new therapeutic goals.

CARDIO inCode-Score measures an individuals genetic risk of coronary heart disease. Taking an individual’s genetic risk into consideration enables physicians to reclassify patients into a higher risk category. It is estimated that 5% of patients clinically classified in the low-risk group and 14% of those in the intermediate-risk group would be reclassified to higher risk categories (Iribarren et al., 2016) where genetic risk is assessed.