AUTHOR=Knowles Joshua W. , Zarafshar Shirin , Pavlovic Aleksandra , Goldstein Benjamin A. , Tsai Sandra , Li Jin , McConnell Michael V. , Absher Devin , Ashley Euan A. , Kiernan Michaela , Ioannidis John P. A. , Assimes Themistocles L. 

TITLE=Impact of a Genetic Risk Score for Coronary Artery Disease on Reducing Cardiovascular Risk: A Pilot Randomized Controlled Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 4 - 2017

YEAR=2017

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2017.00053

DOI=10.3389/fcvm.2017.00053

ISSN=2297-055X

ABSTRACT=Purpose: We tested whether providing a genetic risk score (GRS) for coronary artery disease (CAD) would serve as a motivator to improve adherence to risk-reducing strategies. 
Methods: We randomized 94 participants with at least moderate risk of CAD to receive standard-of-care with (N=49) or without (N=45) their GRS at a subsequent 3-month follow-up visit. Our primary outcome was change in LDL-cholesterol between the 3-month and 6-month follow-up visits (ΔLDL-C). Secondary outcomes included other CAD risk factors, weight loss, diet, physical activity, risk perceptions, and psychological outcomes. In pre-specified analyses, we examined whether there was a greater motivational effect in participants with a higher GRS.
Results: Sixty-five participants completed the protocol including 30 participants in the GRS arm. We found no change in the primary outcome between participants receiving their GRS and standard-of-care participants (ΔLDL-C: -13 vs. -9mg/dl). Among participants with a higher GRS, we observed modest effects on weight loss and physical activity. All other secondary outcomes were not significantly different, including anxiety and worry. 
Conclusion: Adding GRS to standard-of-care did not change lipids, adherence, or psychological outcomes. Potential modest benefits in weight loss and physical activity for participants with high GRS need to be validated in larger trials.