Evidence map›Paper›PMID 42658146›Full record

ArticleJACC. Asia2026

Cost-Effectiveness of Polygenic Risk Score-Guided Statin Therapy for Cardiovascular Disease Prevention in Singapore.

Irene Li Peng Ooi, Aloysius Wei-Yan Chia, Ying Jie Chee, Liuh Ling Goh, Khai Pang Leong, Sanchalika Acharyya, Rinkoo Dalan, Akshar Saxena

Abstract read
In one paragraph

Article in JACC. Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Irene Li Peng OoiDivision of Economics, Nanyang Technological University, Singapore, Singapore.
Aloysius Wei-Yan ChiaDepartment of Endocrinology, KLARIS Precision Health Research Clinic, Tan Tock Seng Hospital, NHG Health, Singapore, Singapore.
Ying Jie CheeDepartment of Endocrinology, KLARIS Precision Health Research Clinic, Tan Tock Seng Hospital, NHG Health, Singapore, Singapore.
Liuh Ling GohMolecular Diagnostic Laboratory, Tan Tock Seng Hospital, NHG Health, Singapore, Singapore.
Khai Pang LeongDepartment of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, NHG Health, Singapore, Singapore.
Sanchalika AcharyyaDepartment of Endocrinology, KLARIS Precision Health Research Clinic, Tan Tock Seng Hospital, NHG Health, Singapore, Singapore.
Rinkoo DalanDepartment of Endocrinology, KLARIS Precision Health Research Clinic, Tan Tock Seng Hospital, NHG Health, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. Electronic address: rinkoo.dalan@nhghealth.com.sg.
Akshar SaxenaDivision of Economics, Nanyang Technological University, Singapore, Singapore. Electronic address: aksharsaxena@ntu.edu.sg.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in Singapore. Under current guidelines, individuals at intermediate risk often do not receive preventive statin therapy despite potentially elevated genetic risk. Polygenic risk scores (PRSs) offer an opportunity to refine risk stratification, but their economic value in Asian health care settings remains uncertain.

objectivesThe authors aimed to evaluate the cost-effectiveness of PRS-guided risk assessment for a cohort of 45-year-old Singapore residents with intermediate (7.5%-20%) 10-year ASCVD risk.

methodsWe developed a state-transition Markov model comparing 2 strategies: 1) standard risk assessment using the pooled cohort equation, with statin initiation based on traditional risk factors; and 2) PRS-guided reclassification, with statin therapy initiated for individuals in the top 20% of the PRS distribution. Model inputs were derived from the literature as well as local registry data. Outcomes were evaluated from the health care payer perspective over 2- to 40-year horizons. Deterministic and probabilistic sensitivity analyses were conducted.

resultsPRS-guided therapy was not cost-effective over 2- to 20-year horizons. From 30 years onward, it became cost-effective (Singapore dollars [SGD]) at a willingness-to-pay threshold of SGD 75,000/quality-adjusted life year (QALY), with an incremental cost-effectiveness ratio of SGD 60,334/QALY at 30 years and SGD 23,667/QALY at 40 years. Probabilistic analysis showed a 53.5% probability of cost-effectiveness, with mean incremental cost and effectiveness of SGD 292 (95% uncertainty interval [UI]: -SGD 490 to SGD 1,052) and 0.010 QALYs (95% UI: -0.062 to 0.087), respectively.

conclusionsIncorporating PRS into ASCVD risk stratification for intermediate-risk individuals in Singapore may represent a cost-effective long-term prevention strategy as benefits of avoided ASCVD events accumulate.

Indexed as

cardiovascular disease preventioncost-effectivenesspolygenic risk scoreprecision medicineSingaporestatin therapy

Identifiers

PMID42658146
PMCPMC13654358

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.