The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here:

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

Photo: KG Pressfoto

Marju Orho-Melander


Photo: KG Pressfoto

Polygenic Risk Score for Coronary Heart Disease Modifies the Elevated Risk by Cigarette Smoking for Disease Incidence


  • George Hindy
  • Frans Wiberg
  • Peter Almgren
  • Olle Melander
  • Marju Orho-Melander

Summary, in English

BACKGROUND: Coronary heart disease (CHD) is a multifactorial disease with both genetic and environmental components. Smoking is the most important modifiable risk factor for CHD. Our aim was to test whether the increased CHD incidence by smoking is modified by genetic predisposition to CHD. METHODS AND RESULTS: Our study included 24 443 individuals from the MDCS (Malmö Diet and Cancer Study). A weighted polygenic risk score (PRS) was created by summing the number of risk alleles for 50 single-nucleotide polymorphisms associated with CHD. Individuals were classified as current, former, or never smokers. Interactions were primarily tested between smoking status and PRS and secondarily with individual single-nucleotide polymorphisms. Then, the predictive use of PRS for CHD incidence was tested among different smoking categories. During a median follow-up time of 19.4 years, 3217 incident CHD cases were recorded. The association between smoking and CHD was modified by the PRS (Pinteraction=0.005). The magnitude of increased incidence of CHD by smoking was highest among individuals in the lowest tertile of PRS (odds ratio, 1.42; 95% confidence interval, 1.29-1.56 per smoking risk category) compared with the highest tertile (odds ratio, 1.20; 95% confidence interval, 1.11-1.30 per smoking risk category). This interaction was stronger among men (Pinteraction=0.001) compared with women (Pinteraction=0.44). The PRS provided a significantly better net reclassification and discrimination on top of traditional risk factors among never smokers compared with current smokers (P<0.001). CONCLUSIONS: Genetic predisposition to CHD modifies the associated increased CHD risk by smoking. The PRS has a better predictive use among never smokers compared with smokers.


  • EXODIAB: Excellence of Diabetes Research in Sweden
  • Diabetes - Cardiovascular Disease
  • Department of Clinical Sciences, Malmö
  • Cardiovascular Research - Hypertension
  • EpiHealth: Epidemiology for Health

Publishing year





Circulation: Genomic and Precision Medicine





Document type

Journal article


Lippincott Williams & Wilkins


  • Cardiac and Cardiovascular Systems


  • cigarette smoking
  • coronary disease
  • gene-environment interaction
  • genetic predisposition to disease
  • ppolymorphism, genetic
  • smoking



Research group

  • Diabetes - Cardiovascular Disease
  • Cardiovascular Research - Hypertension


  • ISSN: 2574-8300