What is new

1. This is the first multisociety consensus addressing the clinical integration of polygenic risk in cardiovascular prevention in Mexico.

2. Polygenic Risk Scores (PRS) redefine cardiovascular risk as a lifelong trajectory, rather than a short-term probability.

3. A novel three-dimensional model integrating phenotype, anatomy (Coronary Artery Calcium CAC), and genotype (PRS) is proposed as a framework for precision cardiovascular risk stratification.

Clinical implications

1. PRS enables early identification of individuals with accelerated atherosclerotic trajectories, particularly in young adults and those at intermediate risk.

2. The integration of PRS with CAC and traditional risk factors improves clinical decision-making in primary prevention.

3. Implementation should be selective and evidence-based, linked to national validation through the PRS-MX Registry.

4. Precision cardiovascular prevention strategies may optimize resource allocation by targeting individuals with the greatest expected benefit.