{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T14:13:36Z","timestamp":1789568016411,"version":"build-2803163510"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Genomic and Precision Medicine"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Prior work suggests modifiable cardiovascular risk factors (CRFs) account for 80% to 90% of the risk for incident myocardial infarction. The contributions of genetic and other novel CRFs have not been simultaneously assessed in contemporary data sets.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>\n              In the United Kingdom Biobank, CRFs were identified and Cox proportional hazards models with traditional CRFs (hypertension, diabetes, dyslipidemia, waist-to-hip ratio, diet, exercise, alcohol, and socioeconomic deprivation) and contemporary\/genetic CRFs (Lp(a) [lipoprotein(a)], hsCRP [high-sensitivity C-reactive protein], familial hypercholesterolemia variants, and polygenic risk score for coronary artery disease) were constructed for coronary artery disease. Coronary artery disease was defined as a first-time myocardial infarction diagnosis or coronary revascularization. R\n              <jats:sup>2<\/jats:sup>\n              was calculated for each model, and the percent contribution of each individual CRF was calculated by the R\n              <jats:sup>2<\/jats:sup>\n              percent decrease after its removal.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Among 299\u2005707 individuals, the mean (SD) age was 56.2 (8.1) years, and 166\u2005533 (55.6%) were women. Over a median (interquartile range) follow-up of 11.0 (9.6\u201312.5) years, 17\u2005409 (5.8%) of participants developed myocardial infarction. R\n              <jats:sup>2<\/jats:sup>\n              increased from the base model (R\n              <jats:sup>2<\/jats:sup>\n              , 0.021 [0.020\u20130.022]), to the clinical model (R\n              <jats:sup>2<\/jats:sup>\n              , 0.045 [0.043\u20130.046]), to the contemporary\/genetic model (R\n              <jats:sup>2<\/jats:sup>\n              , 0.053 [0.052\u20130.055]). The most powerful individual CRFs were hypertension (R\n              <jats:sup>2<\/jats:sup>\n              loss, 15.2% [14.5\u201317.1]) and polygenic risk score for coronary artery disease (R\n              <jats:sup>2<\/jats:sup>\n              loss, 12.4% [10.8\u201313.3]), followed by dyslipidemia (R\n              <jats:sup>2<\/jats:sup>\n              loss, 3.4% [2.6\u20133.5]), diabetes (R\n              <jats:sup>2<\/jats:sup>\n              loss, 2.2% [1.5\u20132.0]), hsCRP (R\n              <jats:sup>2<\/jats:sup>\n              loss, 1.8% [1.5\u20132.0]), and Lp(a) (R\n              <jats:sup>2<\/jats:sup>\n              loss, 1.5% [1.2\u20131.8]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Novel CRFs like polygenic risk score for coronary artery disease, hsCRP, and Lp(a) have similar importance, comparable to traditional CRFs such as hypertension, dyslipidemia, and diabetes, for incident myocardial infarction, highlighting important identifiable residual risk factors.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circgen.124.004937","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T05:00:21Z","timestamp":1751518821000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Importance of Clinical, Laboratory, and Genetic Risk Factors for Incident CAD"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0782-4753","authenticated-orcid":true,"given":"Romit","family":"Bhattacharya","sequence":"first","affiliation":[{"name":"Department of Medicine, Harvard Medical School (R.B., A.P., A.J., S.H., K.L., M.C.H., P.N.), Massachusetts General Hospital, Boston."},{"name":"Department of Medicine, Cardiovascular Research Center &amp; Center for Genomic Medicine (R.B., S.M.J.C., A.P., Y.R., S.K., M.K., S.H., K.L., M.C.H., S.M.Z., P.N.), Massachusetts General Hospital, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5045-8496","authenticated-orcid":true,"given":"Christopher S.","family":"Marnell","sequence":"additional","affiliation":[{"name":"The Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2460-3335","authenticated-orcid":true,"given":"So Mi Jemma","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harvard Medical School (R.B., A.P., A.J., S.H., K.L., M.C.H., P.N.), Massachusetts General Hospital, Boston."},{"name":"Department of Medicine, Cardiovascular Research Center &amp; Center for Genomic Medicine (R.B., S.M.J.C., A.P., Y.R., S.K., M.K., S.H., K.L., M.C.H., S.M.Z., P.N.), Massachusetts General Hospital, Boston."},{"name":"Integrative Research Center for Cerebrovascular &amp; Cardiovascular Diseases, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea (S.M.J.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7871-9638","authenticated-orcid":true,"given":"Aniruddh P.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harvard Medical School (R.B., A.P., A.J., S.H., K.L., M.C.H., P.N.), Massachusetts General Hospital, Boston."},{"name":"Department of Medicine, Cardiovascular Research Center &amp; Center for Genomic Medicine (R.B., S.M.J.C., A.P., Y.R., S.K., M.K., S.H., K.L., M.C.H., S.M.Z., P.N.), Massachusetts General Hospital, Boston."},{"name":"Program in Medical and Population Genetics &amp; Cardiovascular Disease Initiative, Broad Institute of Harvard &amp; MIT, Cambridge (A.P., Y.R., S.K., M.T., S.H., K.L., M.C.H., S.M.Z., I.S., 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P.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9286-0360","authenticated-orcid":true,"given":"Satoshi","family":"Koyama","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harvard Medical School (R.B., A.P., A.J., S.H., K.L., M.C.H., P.N.), Massachusetts General Hospital, Boston."},{"name":"Department of Medicine, Cardiovascular Research Center &amp; Center for Genomic Medicine (R.B., S.M.J.C., A.P., Y.R., S.K., M.K., S.H., K.L., M.C.H., S.M.Z., P.N.), Massachusetts General Hospital, Boston."},{"name":"Program in Medical and Population Genetics &amp; Cardiovascular Disease Initiative, Broad Institute of Harvard &amp; MIT, Cambridge (A.P., Y.R., S.K., M.T., S.H., K.L., M.C.H., S.M.Z., I.S., P.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9030-0979","authenticated-orcid":true,"given":"Amanda R.","family":"Jowell","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harvard Medical School (R.B., A.P., A.J., S.H., K.L., M.C.H., P.N.), Massachusetts General Hospital, Boston."},{"name":"Department of Medicine, Brigham and Women\u2019s Hospital, Boston, MA (A.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8447-2897","authenticated-orcid":true,"given":"Mark","family":"Trinder","sequence":"additional","affiliation":[{"name":"Program in Medical and Population Genetics &amp; Cardiovascular Disease Initiative, Broad Institute of Harvard &amp; MIT, Cambridge (A.P., Y.R., S.K., M.T., S.H., K.L., M.C.H., S.M.Z., I.S., P.N.)."},{"name":"Centre for Heart Lung Innovation, Department of Medicine, The University of British Columbia, Vancouver, Canada (M.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8588-3388","authenticated-orcid":true,"given":"Sara","family":"Haidermota","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harvard Medical School (R.B., A.P., A.J., S.H., K.L., M.C.H., P.N.), Massachusetts General Hospital, Boston."},{"name":"Department of Medicine, Cardiovascular Research Center &amp; Center for Genomic Medicine (R.B., S.M.J.C., A.P., Y.R., S.K., M.K., S.H., K.L., M.C.H., S.M.Z., P.N.), Massachusetts General Hospital, Boston."},{"name":"Program in Medical and Population Genetics &amp; Cardiovascular Disease Initiative, Broad Institute of Harvard &amp; MIT, Cambridge (A.P., Y.R., S.K., M.T., S.H., K.L., M.C.H., S.M.Z., I.S., P.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Lannery","sequence":"additional","affiliation":[{"name":"Department of Medicine, Harvard Medical School (R.B., A.P., A.J., S.H., K.L., 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