Development and Evaluation of a Comprehensive Prediction Model for Incident Coronary Heart Disease Using Genetic, Social, and Lifestyle–Psychological Factors: A Prospective Analysis of the UK Biobank

BACKGROUND: Clinical risk calculators for coronary heart disease (CHD) do not include genetic, social, and lifestyle-psychological risk factors. OBJECTIVE: To improve CHD risk prediction by developing and evaluating a prediction model that incorporated a polygenic risk score (PRS) and a polysocial score (PSS), the latter including social determinants of health and lifestyle-psychological factors. DESIGN: Cohort study. SETTING: United Kingdom. PARTICIPANTS: UK Biobank participants recruited between 2006 and 2010. MEASUREMENTS: from 100 related covariates. Machine-learning and time-to-event analyses and model performance indices. RESULTS: into PREVENT and QRISK3. LIMITATION: A predominantly White cohort; possible healthy participant effect and ecological fallacy. CONCLUSION: improved the performance of clinical risk calculators. PRIMARY FUNDING SOURCE: National Human Genome Research Institute.