Mega, Stitziel et al. test the clinical use of a multi-locus genetic risk score including a composite of 27 genetic variants associated with coronary heart disease. In community-based and primary or secondary prevention studies, they find that a higher genetic risk score is associated with increased risk of incident or recurrent coronary heart disease events, adjusted for clinical risk factors. Those in the highest genetic risk score categories derived greater benefits from statin preventative therapy, with greater relative and absolute disease risk reductions in randomized controlled trials for primary and secondary prevention. Although further testing in stratified prospective trials will be needed to directly test the clinical benefit of using a genetic risk score as the basis of selective statin therapy, the current study provides an indicator of how genetic screening may prove useful in identifying subpopulations that are more likely to benefit from preventative therapy.