1
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Thorolfsdottir RB, Jonsdottir AB, Sveinbjornsson G, Aegisdottir HM, Oddsson A, Stefansson OA, Halldorsson GH, Saevarsdottir S, Thorleifsson G, Stefansdottir L, Pedersen OB, Sørensen E, Ghouse J, Raja AA, Zheng C, Silajdzija E, Rand SA, Erikstrup C, Ullum H, Mikkelsen C, Banasik K, Brunak S, Ivarsdottir EV, Sigurdsson A, Beyter D, Sturluson A, Einarsson H, Tragante V, Helgason H, Lund SH, Halldorsson BV, Sigurpalsdottir BD, Olafsson I, Arnar DO, Thorgeirsson G, Knowlton KU, Nadauld LD, Gretarsdottir S, Helgadottir A, Ostrowski SR, Gudbjartssson DF, Jonsdottir I, Bundgaard H, Holm H, Sulem P, Stefansson K. Variants at the Interleukin 1 Gene Locus and Pericarditis. JAMA Cardiol 2024; 9:165-172. [PMID: 38150231 PMCID: PMC10753444 DOI: 10.1001/jamacardio.2023.4820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/14/2023] [Indexed: 12/28/2023]
Abstract
Importance Recurrent pericarditis is a treatment challenge and often a debilitating condition. Drugs inhibiting interleukin 1 cytokines are a promising new treatment option, but their use is based on scarce biological evidence and clinical trials of modest sizes, and the contributions of innate and adaptive immune processes to the pathophysiology are incompletely understood. Objective To use human genomics, transcriptomics, and proteomics to shed light on the pathogenesis of pericarditis. Design, Setting, and Participants This was a meta-analysis of genome-wide association studies of pericarditis from 5 countries. Associations were examined between the pericarditis-associated variants and pericarditis subtypes (including recurrent pericarditis) and secondary phenotypes. To explore mechanisms, associations with messenger RNA expression (cis-eQTL), plasma protein levels (pQTL), and CpG methylation of DNA (ASM-QTL) were assessed. Data from Iceland (deCODE genetics, 1983-2020), Denmark (Copenhagen Hospital Biobank/Danish Blood Donor Study, 1977-2022), the UK (UK Biobank, 1953-2021), the US (Intermountain, 1996-2022), and Finland (FinnGen, 1970-2022) were included. Data were analyzed from September 2022 to August 2023. Exposure Genotype. Main Outcomes and Measures Pericarditis. Results In this genome-wide association study of 4894 individuals with pericarditis (mean [SD] age at diagnosis, 51.4 [17.9] years, 2734 [67.6%] male, excluding the FinnGen cohort), associations were identified with 2 independent common intergenic variants at the interleukin 1 locus on chromosome 2q14. The lead variant was rs12992780 (T) (effect allele frequency [EAF], 31%-40%; odds ratio [OR], 0.83; 95% CI, 0.79-0.87; P = 6.67 × 10-16), downstream of IL1B and the secondary variant rs7575402 (A or T) (EAF, 45%-55%; adjusted OR, 0.89; 95% CI, 0.85-0.93; adjusted P = 9.6 × 10-8). The lead variant rs12992780 had a smaller odds ratio for recurrent pericarditis (0.76) than the acute form (0.86) (P for heterogeneity = .03) and rs7575402 was associated with CpG methylation overlapping binding sites of 4 transcription factors known to regulate interleukin 1 production: PU.1 (encoded by SPI1), STAT1, STAT3, and CCAAT/enhancer-binding protein β (encoded by CEBPB). Conclusions and Relevance This study found an association between pericarditis and 2 independent sequence variants at the interleukin 1 gene locus. This finding has the potential to contribute to development of more targeted and personalized therapy of pericarditis with interleukin 1-blocking drugs.
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Affiliation(s)
| | | | | | | | | | | | - Gisli H. Halldorsson
- deCODE genetics, Amgen, Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Saedis Saevarsdottir
- deCODE genetics, Amgen, Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Department of Medicine, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | | | | | - Ole B. Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jonas Ghouse
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Laboratory for Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Anna Axelsson Raja
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Chaoqun Zheng
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Elvira Silajdzija
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Søren Albertsen Rand
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Laboratory for Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Christina Mikkelsen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Karina Banasik
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | | | - Hafsteinn Einarsson
- deCODE genetics, Amgen, Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Hannes Helgason
- deCODE genetics, Amgen, Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Bjarni V. Halldorsson
- deCODE genetics, Amgen, Reykjavik, Iceland
- School of Technology, Reykjavik University, Reykjavik, Iceland
| | - Brynja D. Sigurpalsdottir
- deCODE genetics, Amgen, Reykjavik, Iceland
- School of Technology, Reykjavik University, Reykjavik, Iceland
| | - Isleifur Olafsson
- Department of Clinical Biochemistry, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - David O. Arnar
- deCODE genetics, Amgen, Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Department of Medicine, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Kirk U. Knowlton
- Intermountain Medical Center, Intermountain Heart Institute, Salt Lake City, Utah
- School of Medicine, University of Utah, Salt Lake City
| | - Lincoln D. Nadauld
- Precision Genomics, Intermountain Healthcare, Saint George, Utah
- School of Medicine, Stanford University, Stanford, California
| | | | | | - Sisse R. Ostrowski
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Daniel F. Gudbjartssson
- deCODE genetics, Amgen, Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Ingileif Jonsdottir
- deCODE genetics, Amgen, Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Henning Bundgaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Hilma Holm
- deCODE genetics, Amgen, Reykjavik, Iceland
| | | | - Kari Stefansson
- deCODE genetics, Amgen, Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
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2
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Stacey SN, Zink F, Halldorsson GH, Stefansdottir L, Gudjonsson SA, Einarsson G, Hjörleifsson G, Eiriksdottir T, Helgadottir A, Björnsdottir G, Thorgeirsson TE, Olafsdottir TA, Jonsdottir I, Gretarsdottir S, Tragante V, Magnusson MK, Jonsson H, Gudmundsson J, Olafsson S, Holm H, Gudbjartsson DF, Sulem P, Helgason A, Thorsteinsdottir U, Tryggvadottir L, Rafnar T, Melsted P, Ulfarsson MÖ, Vidarsson B, Thorleifsson G, Stefansson K. Genetics and epidemiology of mutational barcode-defined clonal hematopoiesis. Nat Genet 2023; 55:2149-2159. [PMID: 37932435 PMCID: PMC10703693 DOI: 10.1038/s41588-023-01555-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/28/2023] [Indexed: 11/08/2023]
Abstract
Clonal hematopoiesis (CH) arises when a substantial proportion of mature blood cells is derived from a single hematopoietic stem cell lineage. Using whole-genome sequencing of 45,510 Icelandic and 130,709 UK Biobank participants combined with a mutational barcode method, we identified 16,306 people with CH. Prevalence approaches 50% in elderly participants. Smoking demonstrates a dosage-dependent impact on risk of CH. CH associates with several smoking-related diseases. Contrary to published claims, we find no evidence that CH is associated with cardiovascular disease. We provide evidence that CH is driven by genes that are commonly mutated in myeloid neoplasia and implicate several new driver genes. The presence and nature of a driver mutation alters the risk profile for hematological disorders. Nevertheless, most CH cases have no known driver mutations. A CH genome-wide association study identified 25 loci, including 19 not implicated previously in CH. Splicing, protein and expression quantitative trait loci were identified for CD164 and TCL1A.
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Affiliation(s)
| | | | - Gisli H Halldorsson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | | | | | | | | | | | | | - Thorunn A Olafsdottir
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Ingileif Jonsdottir
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Department of Immunology, Landspitali University Hospital, Reykjavik, Iceland
| | | | | | - Magnus K Magnusson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | | | - Hilma Holm
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Agnar Helgason
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Department of Anthropology, University of Iceland, Reykjavik, Iceland
| | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | - Pall Melsted
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Magnus Ö Ulfarsson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Brynjar Vidarsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Department of Hematology, Landspitali University Hospital, Reykjavik, Iceland
| | | | - Kari Stefansson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland.
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
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3
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Bjornsdottir G, Chalmer MA, Stefansdottir L, Skuladottir AT, Einarsson G, Andresdottir M, Beyter D, Ferkingstad E, Gretarsdottir S, Halldorsson BV, Halldorsson GH, Helgadottir A, Helgason H, Hjorleifsson Eldjarn G, Jonasdottir A, Jonasdottir A, Jonsdottir I, Knowlton KU, Nadauld LD, Lund SH, Magnusson OT, Melsted P, Moore KHS, Oddsson A, Olason PI, Sigurdsson A, Stefansson OA, Saemundsdottir J, Sveinbjornsson G, Tragante V, Unnsteinsdottir U, Walters GB, Zink F, Rødevand L, Andreassen OA, Igland J, Lie RT, Haavik J, Banasik K, Brunak S, Didriksen M, T Bruun M, Erikstrup C, Kogelman LJA, Nielsen KR, Sørensen E, Pedersen OB, Ullum H, Masson G, Thorsteinsdottir U, Olesen J, Ludvigsson P, Thorarensen O, Bjornsdottir A, Sigurdardottir GR, Sveinsson OA, Ostrowski SR, Holm H, Gudbjartsson DF, Thorleifsson G, Sulem P, Stefansson H, Thorgeirsson TE, Hansen TF, Stefansson K. Rare variants with large effects provide functional insights into the pathology of migraine subtypes, with and without aura. Nat Genet 2023; 55:1843-1853. [PMID: 37884687 PMCID: PMC10632135 DOI: 10.1038/s41588-023-01538-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 09/18/2023] [Indexed: 10/28/2023]
Abstract
Migraine is a complex neurovascular disease with a range of severity and symptoms, yet mostly studied as one phenotype in genome-wide association studies (GWAS). Here we combine large GWAS datasets from six European populations to study the main migraine subtypes, migraine with aura (MA) and migraine without aura (MO). We identified four new MA-associated variants (in PRRT2, PALMD, ABO and LRRK2) and classified 13 MO-associated variants. Rare variants with large effects highlight three genes. A rare frameshift variant in brain-expressed PRRT2 confers large risk of MA and epilepsy, but not MO. A burden test of rare loss-of-function variants in SCN11A, encoding a neuron-expressed sodium channel with a key role in pain sensation, shows strong protection against migraine. Finally, a rare variant with cis-regulatory effects on KCNK5 confers large protection against migraine and brain aneurysms. Our findings offer new insights with therapeutic potential into the complex biology of migraine and its subtypes.
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Affiliation(s)
| | - Mona A Chalmer
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet-Glostrup, Copenhagen, Denmark
| | | | | | | | | | | | | | | | - Bjarni V Halldorsson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Reykjavik University, School of Technology, Reykjavik, Iceland
| | - Gisli H Halldorsson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Hannes Helgason
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | | | - Ingileif Jonsdottir
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | - Sigrun H Lund
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Physical Sciences, School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Pall Melsted
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | | | | | | | | | | | | | | | | | | | - Linn Rødevand
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Health and Social Science, Centre for Evidence-Based Practice, Western Norway University of Applied Science, Bergen, Norway
| | - Rolv T Lie
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mie T Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine Health, Aarhus University, Aarhus, Denmark
| | - Lisette J A Kogelman
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet-Glostrup, Copenhagen, Denmark
| | - Kaspar R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ole B Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Unnur Thorsteinsdottir
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Jes Olesen
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet-Glostrup, Copenhagen, Denmark
| | - Petur Ludvigsson
- Department of Pediatrics, Landspitali University Hostpital, Reykjavik, Iceland
| | - Olafur Thorarensen
- Department of Pediatrics, Landspitali University Hostpital, Reykjavik, Iceland
| | | | | | - Olafur A Sveinsson
- Laeknasetrid Clinic, Reykjavik, Iceland
- Department of Neurology, Landspitali University Hospital, Reykjavik, Iceland
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hilma Holm
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
| | - Daniel F Gudbjartsson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | | | | | - Thomas F Hansen
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet-Glostrup, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kari Stefansson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland.
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
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4
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Roychowdhury T, Klarin D, Levin MG, Spin JM, Rhee YH, Deng A, Headley CA, Tsao NL, Gellatly C, Zuber V, Shen F, Hornsby WE, Laursen IH, Verma SS, Locke AE, Einarsson G, Thorleifsson G, Graham SE, Dikilitas O, Pattee JW, Judy RL, Pauls-Verges F, Nielsen JB, Wolford BN, Brumpton BM, Dilmé J, Peypoch O, Juscafresa LC, Edwards TL, Li D, Banasik K, Brunak S, Jacobsen RL, Garcia-Barrio MT, Zhang J, Rasmussen LM, Lee R, Handa A, Wanhainen A, Mani K, Lindholt JS, Obel LM, Strauss E, Oszkinis G, Nelson CP, Saxby KL, van Herwaarden JA, van der Laan SW, van Setten J, Camacho M, Davis FM, Wasikowski R, Tsoi LC, Gudjonsson JE, Eliason JL, Coleman DM, Henke PK, Ganesh SK, Chen YE, Guan W, Pankow JS, Pankratz N, Pedersen OB, Erikstrup C, Tang W, Hveem K, Gudbjartsson D, Gretarsdottir S, Thorsteinsdottir U, Holm H, Stefansson K, Ferreira MA, Baras A, Kullo IJ, Ritchie MD, Christensen AH, Iversen KK, Eldrup N, Sillesen H, Ostrowski SR, Bundgaard H, Ullum H, Burgess S, Gill D, Gallagher K, Sabater-Lleal M, Surakka I, Jones GT, Bown MJ, Tsao PS, Willer CJ, Damrauer SM. Genome-wide association meta-analysis identifies risk loci for abdominal aortic aneurysm and highlights PCSK9 as a therapeutic target. Nat Genet 2023; 55:1831-1842. [PMID: 37845353 PMCID: PMC10632148 DOI: 10.1038/s41588-023-01510-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/22/2023] [Indexed: 10/18/2023]
Abstract
Abdominal aortic aneurysm (AAA) is a common disease with substantial heritability. In this study, we performed a genome-wide association meta-analysis from 14 discovery cohorts and uncovered 141 independent associations, including 97 previously unreported loci. A polygenic risk score derived from meta-analysis explained AAA risk beyond clinical risk factors. Genes at AAA risk loci indicate involvement of lipid metabolism, vascular development and remodeling, extracellular matrix dysregulation and inflammation as key mechanisms in AAA pathogenesis. These genes also indicate overlap between the development of AAA and other monogenic aortopathies, particularly via transforming growth factor β signaling. Motivated by the strong evidence for the role of lipid metabolism in AAA, we used Mendelian randomization to establish the central role of nonhigh-density lipoprotein cholesterol in AAA and identified the opportunity for repurposing of proprotein convertase, subtilisin/kexin-type 9 (PCSK9) inhibitors. This was supported by a study demonstrating that PCSK9 loss of function prevented the development of AAA in a preclinical mouse model.
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Affiliation(s)
- Tanmoy Roychowdhury
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA.
- Department of Genetics, Yale School of Medicine, New Haven, CT, USA.
| | - Derek Klarin
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Michael G Levin
- Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Joshua M Spin
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Yae Hyun Rhee
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Alicia Deng
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Colwyn A Headley
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Noah L Tsao
- Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Corry Gellatly
- Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Verena Zuber
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- UK Dementia Research Institute at Imperial College, Imperial College London, London, UK
| | - Fred Shen
- University of Michigan Medical Scientist Training Program, University of Michigan, Ann Arbor, MI, USA
| | - Whitney E Hornsby
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Ina Holst Laursen
- Department of Clinical Immunology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Shefali S Verma
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Philadelphia, PA, USA
| | - Adam E Locke
- Regeneron Genetics Center, LLC, Tarrytown, NY, USA
| | | | | | - Sarah E Graham
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Ozan Dikilitas
- Department of Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA
- Department of Cardiovascular Medicine and the Gonda Vascular Center, Mayo Clinic Rochester, Rochester, MN, USA
- Mayo Clinician Investigator Training Program, Mayo Clinic Rochester, Rochester, MN, USA
| | | | - Renae L Judy
- Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Ferran Pauls-Verges
- Unit of Genomics of Complex Diseases, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Jonas B Nielsen
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway
| | - Brooke N Wolford
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ben M Brumpton
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jaume Dilmé
- Department of Vascular and Endovascular Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Olga Peypoch
- Unit of Genomics of Complex Diseases, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
- Department of Vascular and Endovascular Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Todd L Edwards
- Division of Epidemiology, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dadong Li
- Regeneron Genetics Center, LLC, Tarrytown, NY, USA
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rikke L Jacobsen
- Department of Clinical Immunology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Minerva T Garcia-Barrio
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Jifeng Zhang
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Lars M Rasmussen
- Department of Clinical Biochemistry, Odense University Hospital, Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense, Denmark
| | - Regent Lee
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Ashok Handa
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Anders Wanhainen
- Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Kevin Mani
- Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden
| | - Jes S Lindholt
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense, Denmark
| | - Lasse M Obel
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense, Denmark
| | - Ewa Strauss
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Grzegorz Oszkinis
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
- Department of Vascular and General Surgery, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Christopher P Nelson
- Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Katie L Saxby
- Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Joost A van Herwaarden
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Sander W van der Laan
- Central Diagnostics Laboratory, Division Laboratories, Pharmacy, and Biomedical genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jessica van Setten
- Department of Cardiology, Division Heart and Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mercedes Camacho
- Unit of Genomics of Complex Diseases, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Frank M Davis
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
| | - Rachael Wasikowski
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jonathan L Eliason
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Dawn M Coleman
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Peter K Henke
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Santhi K Ganesh
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Y Eugene Chen
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Weihua Guan
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - James S Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Nathan Pankratz
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Ole B Pedersen
- Department of Clinical Immunology, Zealand University Hospital-Køge, Køge, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Weihong Tang
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Kristian Hveem
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Daniel Gudbjartsson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Aris Baras
- Regeneron Genetics Center, LLC, Tarrytown, NY, USA
| | - Iftikhar J Kullo
- Department of Cardiovascular Medicine and the Gonda Vascular Center, Mayo Clinic Rochester, Rochester, MN, USA
| | - Marylyn D Ritchie
- Department of Genetics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Alex H Christensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kasper K Iversen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Nikolaj Eldrup
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Vascular Surgery, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Henrik Sillesen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | | | - Stephen Burgess
- MRC Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Chief Scientific Advisor Office, Research and Early Development, Novo Nordisk, Copenhagen, Denmark
| | - Katherine Gallagher
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA
| | - Maria Sabater-Lleal
- Unit of Genomics of Complex Diseases, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
- Cardiovascular Medicine Unit, Department of Medicine, Karolinska Institutet, Center for Molecular Medicine, Stockholm, Sweden
| | - Ida Surakka
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Gregory T Jones
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Matthew J Bown
- Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Philip S Tsao
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Cristen J Willer
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA.
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA.
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA.
| | - Scott M Damrauer
- Department of Surgery, Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA.
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
- Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
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5
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Helgason H, Eiriksdottir T, Ulfarsson MO, Choudhary A, Lund SH, Ivarsdottir EV, Hjorleifsson Eldjarn G, Einarsson G, Ferkingstad E, Moore KHS, Honarpour N, Liu T, Wang H, Hucko T, Sabatine MS, Morrow DA, Giugliano RP, Ostrowski SR, Pedersen OB, Bundgaard H, Erikstrup C, Arnar DO, Thorgeirsson G, Masson G, Magnusson OT, Saemundsdottir J, Gretarsdottir S, Steinthorsdottir V, Thorleifsson G, Helgadottir A, Sulem P, Thorsteinsdottir U, Holm H, Gudbjartsson D, Stefansson K. Evaluation of Large-Scale Proteomics for Prediction of Cardiovascular Events. JAMA 2023; 330:725-735. [PMID: 37606673 PMCID: PMC10445198 DOI: 10.1001/jama.2023.13258] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/29/2023] [Indexed: 08/23/2023]
Abstract
Importance Whether protein risk scores derived from a single plasma sample could be useful for risk assessment for atherosclerotic cardiovascular disease (ASCVD), in conjunction with clinical risk factors and polygenic risk scores, is uncertain. Objective To develop protein risk scores for ASCVD risk prediction and compare them to clinical risk factors and polygenic risk scores in primary and secondary event populations. Design, Setting, and Participants The primary analysis was a retrospective study of primary events among 13 540 individuals in Iceland (aged 40-75 years) with proteomics data and no history of major ASCVD events at recruitment (study duration, August 23, 2000 until October 26, 2006; follow-up through 2018). We also analyzed a secondary event population from a randomized, double-blind lipid-lowering clinical trial (2013-2016), consisting of individuals with stable ASCVD receiving statin therapy and for whom proteomic data were available for 6791 individuals. Exposures Protein risk scores (based on 4963 plasma protein levels and developed in a training set in the primary event population); polygenic risk scores for coronary artery disease and stroke; and clinical risk factors that included age, sex, statin use, hypertension treatment, type 2 diabetes, body mass index, and smoking status at the time of plasma sampling. Main Outcomes and Measures Outcomes were composites of myocardial infarction, stroke, and coronary heart disease death or cardiovascular death. Performance was evaluated using Cox survival models and measures of discrimination and reclassification that accounted for the competing risk of non-ASCVD death. Results In the primary event population test set (4018 individuals [59.0% women]; 465 events; median follow-up, 15.8 years), the protein risk score had a hazard ratio (HR) of 1.93 per SD (95% CI, 1.75 to 2.13). Addition of protein risk score and polygenic risk scores significantly increased the C index when added to a clinical risk factor model (C index change, 0.022 [95% CI, 0.007 to 0.038]). Addition of the protein risk score alone to a clinical risk factor model also led to a significantly increased C index (difference, 0.014 [95% CI, 0.002 to 0.028]). Among White individuals in the secondary event population (6307 participants; 432 events; median follow-up, 2.2 years), the protein risk score had an HR of 1.62 per SD (95% CI, 1.48 to 1.79) and significantly increased C index when added to a clinical risk factor model (C index change, 0.026 [95% CI, 0.011 to 0.042]). The protein risk score was significantly associated with major adverse cardiovascular events among individuals of African and Asian ancestries in the secondary event population. Conclusions and Relevance A protein risk score was significantly associated with ASCVD events in primary and secondary event populations. When added to clinical risk factors, the protein risk score and polygenic risk score both provided statistically significant but modest improvement in discrimination.
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Affiliation(s)
- Hannes Helgason
- deCODE genetics/Amgen, Inc, Reykjavik, Iceland
- University of Iceland, Reykjavik, Iceland
| | | | - Magnus O. Ulfarsson
- deCODE genetics/Amgen, Inc, Reykjavik, Iceland
- University of Iceland, Reykjavik, Iceland
| | | | | | | | | | | | | | | | | | | | - Huei Wang
- Amgen, Inc, Thousand Oaks, California
| | | | - Marc S. Sabatine
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - David A. Morrow
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Robert P. Giugliano
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Henning Bundgaard
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - David O. Arnar
- deCODE genetics/Amgen, Inc, Reykjavik, Iceland
- University of Iceland, Reykjavik, Iceland
- Landspitali—The National University Hospital of Iceland, Reykjavik, Iceland
| | - Gudmundur Thorgeirsson
- deCODE genetics/Amgen, Inc, Reykjavik, Iceland
- University of Iceland, Reykjavik, Iceland
- Landspitali—The National University Hospital of Iceland, Reykjavik, Iceland
| | | | | | | | | | | | | | | | | | | | - Hilma Holm
- deCODE genetics/Amgen, Inc, Reykjavik, Iceland
| | - Daniel Gudbjartsson
- deCODE genetics/Amgen, Inc, Reykjavik, Iceland
- University of Iceland, Reykjavik, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen, Inc, Reykjavik, Iceland
- University of Iceland, Reykjavik, Iceland
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6
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Aegisdottir HM, Thorolfsdottir RB, Sveinbjornsson G, Stefansson OA, Gunnarsson B, Tragante V, Thorleifsson G, Stefansdottir L, Thorgeirsson TE, Ferkingstad E, Sulem P, Norddahl G, Rutsdottir G, Banasik K, Christensen AH, Mikkelsen C, Pedersen OB, Brunak S, Bruun MT, Erikstrup C, Jacobsen RL, Nielsen KR, Sørensen E, Frigge ML, Hjorleifsson KE, Ivarsdottir EV, Helgadottir A, Gretarsdottir S, Steinthorsdottir V, Oddsson A, Eggertsson HP, Halldorsson GH, Jones DA, Anderson JL, Knowlton KU, Nadauld LD, Haraldsson M, Thorgeirsson G, Bundgaard H, Arnar DO, Thorsteinsdottir U, Gudbjartsson DF, Ostrowski SR, Holm H, Stefansson K. Genetic variants associated with syncope implicate neural and autonomic processes. Eur Heart J 2023; 44:1070-1080. [PMID: 36747475 DOI: 10.1093/eurheartj/ehad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 11/22/2022] [Accepted: 01/05/2023] [Indexed: 02/08/2023] Open
Abstract
AIMS Syncope is a common and clinically challenging condition. In this study, the genetics of syncope were investigated to seek knowledge about its pathophysiology and prognostic implications. METHODS AND RESULTS This genome-wide association meta-analysis included 56 071 syncope cases and 890 790 controls from deCODE genetics (Iceland), UK Biobank (United Kingdom), and Copenhagen Hospital Biobank Cardiovascular Study/Danish Blood Donor Study (Denmark), with a follow-up assessment of variants in 22 412 cases and 286 003 controls from Intermountain (Utah, USA) and FinnGen (Finland). The study yielded 18 independent syncope variants, 17 of which were novel. One of the variants, p.Ser140Thr in PTPRN2, affected syncope only when maternally inherited. Another variant associated with a vasovagal reaction during blood donation and five others with heart rate and/or blood pressure regulation, with variable directions of effects. None of the 18 associations could be attributed to cardiovascular or other disorders. Annotation with regard to regulatory elements indicated that the syncope variants were preferentially located in neural-specific regulatory regions. Mendelian randomization analysis supported a causal effect of coronary artery disease on syncope. A polygenic score (PGS) for syncope captured genetic correlation with cardiovascular disorders, diabetes, depression, and shortened lifespan. However, a score based solely on the 18 syncope variants performed similarly to the PGS in detecting syncope risk but did not associate with other disorders. CONCLUSION The results demonstrate that syncope has a distinct genetic architecture that implicates neural regulatory processes and a complex relationship with heart rate and blood pressure regulation. A shared genetic background with poor cardiovascular health was observed, supporting the importance of a thorough assessment of individuals presenting with syncope.
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Affiliation(s)
- Hildur M Aegisdottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
| | | | | | | | | | | | | | | | | | - Egil Ferkingstad
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | - Patrick Sulem
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | | | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3A, Copenhagen 2200, Denmark
| | - Alex Hoerby Christensen
- The Unit for Inherited Cardiac Diseases, Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 1, Herlev 2730, Denmark
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
| | - Christina Mikkelsen
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Blegdamsvej 3A, Copenhagen 2200, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
- Department of Clinical Immunology, Zealand University Hospital - Køge, Lykkebækvej 1, Køge 4600, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3A, Copenhagen 2200, Denmark
| | - Mie Topholm Bruun
- Department of Clinical Immunology, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus 8200, Denmark
- Department of Clinical Medicine, Aarhus University, Nordre Ringgade 1, Aarhus 8000, Denmark
| | - Rikke Louise Jacobsen
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Kaspar Rene Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Urbansgade 32, Aalborg 9000, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Michael L Frigge
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | | | - Anna Helgadottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | | | - Asmundur Oddsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | | | - David A Jones
- Precision Genomics, Intermountain Healthcare, 600 S. Medical Center Drive, Saint George, UT 84790, USA
| | - Jeffrey L Anderson
- Intermountain Medical Center, Intermountain Heart Institute, 5171 S. Cottonwood Street Building 1, Salt Lake City, UT 84107, USA
- Department of Internal Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT 84132, USA
| | - Kirk U Knowlton
- Intermountain Medical Center, Intermountain Heart Institute, 5171 S. Cottonwood Street Building 1, Salt Lake City, UT 84107, USA
- School of Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT 84132, USA
| | - Lincoln D Nadauld
- Precision Genomics, Intermountain Healthcare, 600 S. Medical Center Drive, Saint George, UT 84790, USA
- School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA 94305, USA
| | | | - Magnus Haraldsson
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
- Department of Psychiatry, Landspitali, The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland
| | - Gudmundur Thorgeirsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
- Department of Medicine, Landspitali, The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland
| | - Henning Bundgaard
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
- The Capital Regions Unit for Inherited Cardiac Diseases, Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - David O Arnar
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
- Department of Medicine, Landspitali, The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland
| | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Hjardarhagi 4, Reykjavik 107, Iceland
| | - Sisse R Ostrowski
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
- Department of Clinical Immunology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Hilma Holm
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
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7
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Ghouse J, Tragante V, Ahlberg G, Rand SA, Jespersen JB, Leinøe EB, Vissing CR, Trudsø L, Jonsdottir I, Banasik K, Brunak S, Ostrowski SR, Pedersen OB, Sørensen E, Erikstrup C, Bruun MT, Nielsen KR, Køber L, Christensen AH, Iversen K, Jones D, Knowlton KU, Nadauld L, Halldorsson GH, Ferkingstad E, Olafsson I, Gretarsdottir S, Onundarson PT, Sulem P, Thorsteinsdottir U, Thorgeirsson G, Gudbjartsson DF, Stefansson K, Holm H, Olesen MS, Bundgaard H. Genome-wide meta-analysis identifies 93 risk loci and enables risk prediction equivalent to monogenic forms of venous thromboembolism. Nat Genet 2023; 55:399-409. [PMID: 36658437 DOI: 10.1038/s41588-022-01286-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/13/2022] [Indexed: 01/21/2023]
Abstract
We report a genome-wide association study of venous thromboembolism (VTE) incorporating 81,190 cases and 1,419,671 controls sampled from six cohorts. We identify 93 risk loci, of which 62 are previously unreported. Many of the identified risk loci are at genes encoding proteins with functions converging on the coagulation cascade or platelet function. A VTE polygenic risk score (PRS) enabled effective identification of both high- and low-risk individuals. Individuals within the top 0.1% of PRS distribution had a VTE risk similar to homozygous or compound heterozygous carriers of the variants G20210A (c.*97 G > A) in F2 and p.R534Q in F5. We also document that F2 and F5 mutation carriers in the bottom 10% of the PRS distribution had a risk similar to that of the general population. We further show that PRS improved individual risk prediction beyond that of genetic and clinical risk factors. We investigated the extent to which venous and arterial thrombosis share clinical risk factors using Mendelian randomization, finding that some risk factors for arterial thrombosis were directionally concordant with VTE risk (for example, body mass index and smoking) whereas others were discordant (for example, systolic blood pressure and triglyceride levels).
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Affiliation(s)
- Jonas Ghouse
- Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
- Laboratory for Molecular Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | | | - Gustav Ahlberg
- Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Laboratory for Molecular Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren A Rand
- Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Laboratory for Molecular Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jakob B Jespersen
- Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Laboratory for Molecular Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Eva Birgitte Leinøe
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Linea Trudsø
- Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Laboratory for Molecular Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ingileif Jonsdottir
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Iceland Department of Immunology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Karina Banasik
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Brunak
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ole B Pedersen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Immunology, Næstved Hospital, Næstved, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Mie Topholm Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Kaspar Rene Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Lars Køber
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Alex H Christensen
- Department of Cardiology, Copenhagen University Hospital, Herlev-Gentofte Hospital, Herlev, Denmark
| | - Kasper Iversen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital, Herlev-Gentofte Hospital, Herlev, Denmark
| | - David Jones
- Precision Genomics, Intermountain Healthcare, Saint George, UT, USA
| | - Kirk U Knowlton
- Intermountain Medical Center, Intermountain Heart Institute, Salt Lake City, UT, USA
- University of Utah, School of Medicine, Salt Lake City, UT, USA
| | - Lincoln Nadauld
- Precision Genomics, Intermountain Healthcare, Saint George, UT, USA
- Stanford University, School of Medicine, Stanford, CA, USA
| | | | | | | | | | - Pall T Onundarson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Laboratory Hematology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Gudmundur Thorgeirsson
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- Department of Medicine, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
| | - Morten Salling Olesen
- Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Laboratory for Molecular Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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8
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Helgadottir A, Thorleifsson G, Snaebjarnarson A, Stefansdottir L, Sveinbjornsson G, Tragante V, Björnsson E, Steinthorsdottir V, Gretarsdottir S, Helgason H, Saemundsdottir J, Olafsson I, Thune JJ, Raja AA, Ghouse J, Olesen MS, Christensen A, Jacobsen RL, Dowsett J, Bruun MT, Nielsen K, Knowlton K, Nadauld L, Benediktsson R, Erikstrup C, Pedersen OB, Banasik K, Brunak S, Bundgaard H, Ostrowski SR, Sulem P, Arnar DO, Thorgeirsson G, Thorsteinsdottir U, Gudbjartsson DF, Stefansson K, Holm H. Cholesterol not particle concentration mediates the atherogenic risk conferred by apolipoprotein B particles: a Mendelian randomization analysis. Eur J Prev Cardiol 2022; 29:2374-2385. [PMID: 36125206 DOI: 10.1093/eurjpc/zwac219] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/23/2022] [Accepted: 09/19/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS The causal contribution of apolipoprotein B (apoB) particles to coronary artery disease (CAD) is established. We examined whether this atherogenic contribution is better reflected by non-high-density lipoprotein cholesterol (non-HDL-C) or apoB particle concentration. METHOD AND RESULTS We performed Mendelian randomization (MR) analysis using 235 variants as genetic instruments; testing the relationship between their effects on the exposures, non-HDL-C and apoB, and on the outcome CAD using weighted regression. Variant effect estimates on the exposures came from the UK Biobank (N = 376 336) and on the outcome from a meta-analysis of five CAD datasets (187 451 cases and 793 315 controls). Subsequently, we carried out sensitivity and replication analyses.In univariate MR analysis, both exposures associated with CAD (βnon-HDL-C = 0.40, P = 2.8 × 10-48 and βapoB = 0.38, P = 1.3 × 10-44). Adding effects on non-HDL-C into a model that already included those on apoB significantly improved the genetically predicted CAD effects (P = 3.9 × 10-5), while adding apoB into the model including non-HDL-C did not (P = 0.69). Thirty-five per cent (82/235) of the variants used as genetic instruments had discordant effects on the exposures, associating with non-HDL-C/apoB ratio at P < 2.1 × 10-4 (0.05/235). Fifty-one variants associated at genome-wide significance. CONCLUSION Many sequence variants have discordant effects on non-HDL-C and apoB. These variants allowed us to show that the causal mechanism underlying the relationship between apolipoprotein B particles and CAD is more associated with non-HDL-C than apoB particle concentration.
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Affiliation(s)
- Anna Helgadottir
- deCODE Genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | | | | | | | | | - Eyþór Björnsson
- deCODE Genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | | | - Hannes Helgason
- deCODE Genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | - Isleifur Olafsson
- Department of Clinical Biochemistry, Landspitali - The National University Hospital of Iceland, Reykjavik 101, Iceland
| | - Jens Jakob Thune
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Anna Axelsson Raja
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Jonas Ghouse
- Laboratory for Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Laboratory for Molecular Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Morten Salling Olesen
- Laboratory for Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Laboratory for Molecular Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Alex Christensen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Rikke Louise Jacobsen
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Joseph Dowsett
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mie Topholm Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Kaspar Nielsen
- Department of Clicnical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | | | | | - Rafn Benediktsson
- Department of Medicine, Landspitali - The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Ole B Pedersen
- Department of Clinical Immunology, Zealand University Hospital-Køge, Køge, Denmark
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Henning Bundgaard
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Patrick Sulem
- deCODE Genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | - David O Arnar
- deCODE Genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland.,Department of Medicine, Landspitali - The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
| | - Gudmundur Thorgeirsson
- deCODE Genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
| | - Unnur Thorsteinsdottir
- deCODE Genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
| | - Daniel F Gudbjartsson
- deCODE Genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland.,School of Engineering and Natural Sciences, University of Iceland, Hjardarhagi 4, Reykjavik 107, Iceland
| | - Kari Stefansson
- deCODE Genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
| | - Hilma Holm
- deCODE Genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
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9
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Thorolfsdottir RB, Sveinbjornsson G, Aegisdottir HM, Benonisdottir S, Stefansdottir L, Ivarsdottir EV, Halldorsson GH, Sigurdsson JK, Torp-Pedersen C, Weeke PE, Brunak S, Westergaard D, Pedersen OB, Sorensen E, Nielsen KR, Burgdorf KS, Banasik K, Brumpton B, Zhou W, Oddsson A, Tragante V, Hjorleifsson KE, Davidsson OB, Rajamani S, Jonsson S, Torfason B, Valgardsson AS, Thorgeirsson G, Frigge ML, Thorleifsson G, Norddahl GL, Helgadottir A, Gretarsdottir S, Sulem P, Jonsdottir I, Willer CJ, Hveem K, Bundgaard H, Ullum H, Arnar DO, Thorsteinsdottir U, Gudbjartsson DF, Holm H, Stefansson K. Genetic insight into sick sinus syndrome. Eur Heart J 2021; 42:1959-1971. [PMID: 36282123 PMCID: PMC8140484 DOI: 10.1093/eurheartj/ehaa1108] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/24/2020] [Accepted: 01/05/2021] [Indexed: 12/19/2022] Open
Abstract
Aims The aim of this study was to use human genetics to investigate the pathogenesis of sick sinus syndrome (SSS) and the role of risk factors in its development. Methods and results We performed a genome-wide association study of 6469 SSS cases and 1 000 187 controls from deCODE genetics, the Copenhagen Hospital Biobank, UK Biobank, and the HUNT study. Variants at six loci associated with SSS, a reported missense variant in MYH6, known atrial fibrillation (AF)/electrocardiogram variants at PITX2, ZFHX3, TTN/CCDC141, and SCN10A and a low-frequency (MAF = 1.1–1.8%) missense variant, p.Gly62Cys in KRT8 encoding the intermediate filament protein keratin 8. A full genotypic model best described the p.Gly62Cys association (P = 1.6 × 10−20), with an odds ratio (OR) of 1.44 for heterozygotes and a disproportionally large OR of 13.99 for homozygotes. All the SSS variants increased the risk of pacemaker implantation. Their association with AF varied and p.Gly62Cys was the only variant not associating with any other arrhythmia or cardiovascular disease. We tested 17 exposure phenotypes in polygenic score (PGS) and Mendelian randomization analyses. Only two associated with the risk of SSS in Mendelian randomization, AF, and lower heart rate, suggesting causality. Powerful PGS analyses provided convincing evidence against causal associations for body mass index, cholesterol, triglycerides, and type 2 diabetes (P > 0.05). Conclusion We report the associations of variants at six loci with SSS, including a missense variant in KRT8 that confers high risk in homozygotes and points to a mechanism specific to SSS development. Mendelian randomization supports a causal role for AF in the development of SSS.
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Affiliation(s)
| | | | | | | | | | | | | | - Jon K Sigurdsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | - Christian Torp-Pedersen
- Department of Clinical Research and Cardiology, Nordsjaelland Hospital, Dyrehavevej 29, Hillerød 3400, Denmark
| | - Peter E Weeke
- Department of Cardiology, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3A, Copenhagen 2200, Denmark
| | - David Westergaard
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3A, Copenhagen 2200, Denmark
| | - Ole B Pedersen
- Department of Clinical Immunology, Naestved Hospital, Ringstedgade 77B, Naestved 4700, Denmark
| | - Erik Sorensen
- Department of Clinical Immunology, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Kaspar R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital North, Urbansgade 36, Aalborg 9000, Denmark
| | - Kristoffer S Burgdorf
- Department of Clinical Immunology, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3A, Copenhagen 2200, Denmark
| | - Ben Brumpton
- Department of Thoracic and Occupational Medicine, St. Olavs Hospital, Trondheim University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Wei Zhou
- Department of Computational Medicine and Bioinformatics, University of Michigan, 100 Washtenaw Avenue, Ann Arbor, MI 48109-2218, USA
| | - Asmundur Oddsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | - Kristjan E Hjorleifsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland.,Department of Computing and Mathematical Sciences, California Institute of Technology, 1200 E California Blvd. MC 305-16, Pasadena, CA 91125, USA
| | | | | | - Stefan Jonsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | - Bjarni Torfason
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland.,Department of Cardiothoracic Surgery, Landspitali-The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland
| | - Atli S Valgardsson
- Department of Cardiothoracic Surgery, Landspitali-The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland
| | - Gudmundur Thorgeirsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland.,Department of Medicine, Landspitali-The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland
| | - Michael L Frigge
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | | | - Anna Helgadottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | | | - Patrick Sulem
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | - Ingileif Jonsdottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland.,Department of Immunology, Landspitali-The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland
| | - Cristen J Willer
- Department of Computational Medicine and Bioinformatics, University of Michigan, 100 Washtenaw Avenue, Ann Arbor, MI 48109-2218, USA.,Department of Internal Medicine: Cardiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109 -5368, USA.,Department of Human Genetics, University of Michigan, 4909 Buhl Building, 1241 E. Catherine St., Ann Arbor, MI 48109 -5618, USA
| | - Kristian Hveem
- K.G. Jebsen Center for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Erling Skjalgssons gt. 1, Trondheim 7491, Norway.,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, Trondheim 7491, Norway.,HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Forskningsveien 2, Levanger 7600, Norway
| | - Henning Bundgaard
- Department of Cardiology, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Henrik Ullum
- Department of Clinical Immunology, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark.,Statens Serum Institut, Artillerivej 5, Copenhagen 2300, Denmark
| | - David O Arnar
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland.,Department of Medicine, Landspitali-The National University Hospital of Iceland, Hringbraut, Reykjavik 101, Iceland
| | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland.,School of Engineering and Natural Sciences, University of Iceland, Hjardarhagi 4, Reykjavik 107, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik 101, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik 101, Iceland
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10
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Helgadottir A, Thorleifsson G, Alexandersson KF, Tragante V, Thorsteinsdottir M, Eiriksson FF, Gretarsdottir S, Björnsson E, Magnusson O, Sveinbjornsson G, Jonsdottir I, Steinthorsdottir V, Ferkingstad E, Jensson BÖ, Stefansson H, Olafsson I, Christensen AH, Torp-Pedersen C, Køber L, Pedersen OB, Erikstrup C, Sørensen E, Brunak S, Banasik K, Hansen TF, Nyegaard M, Eyjolfssson GI, Sigurdardottir O, Thorarinsson BL, Matthiasson SE, Steingrimsdottir T, Bjornsson ES, Danielsen R, Asselbergs FW, Arnar DO, Ullum H, Bundgaard H, Sulem P, Thorsteinsdottir U, Thorgeirsson G, Holm H, Gudbjartsson DF, Stefansson K. Genetic variability in the absorption of dietary sterols affects the risk of coronary artery disease. Eur Heart J 2021; 41:2618-2628. [PMID: 32702746 PMCID: PMC7377579 DOI: 10.1093/eurheartj/ehaa531] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/19/2020] [Accepted: 06/08/2020] [Indexed: 01/01/2023] Open
Abstract
AIMS To explore whether variability in dietary cholesterol and phytosterol absorption impacts the risk of coronary artery disease (CAD) using as instruments sequence variants in the ABCG5/8 genes, key regulators of intestinal absorption of dietary sterols. METHODS AND RESULTS We examined the effects of ABCG5/8 variants on non-high-density lipoprotein (non-HDL) cholesterol (N up to 610 532) and phytosterol levels (N = 3039) and the risk of CAD in Iceland, Denmark, and the UK Biobank (105 490 cases and 844 025 controls). We used genetic scores for non-HDL cholesterol to determine whether ABCG5/8 variants confer greater risk of CAD than predicted by their effect on non-HDL cholesterol. We identified nine rare ABCG5/8 coding variants with substantial impact on non-HDL cholesterol. Carriers have elevated phytosterol levels and are at increased risk of CAD. Consistent with impact on ABCG5/8 transporter function in hepatocytes, eight rare ABCG5/8 variants associate with gallstones. A genetic score of ABCG5/8 variants predicting 1 mmol/L increase in non-HDL cholesterol associates with two-fold increase in CAD risk [odds ratio (OR) = 2.01, 95% confidence interval (CI) 1.75-2.31, P = 9.8 × 10-23] compared with a 54% increase in CAD risk (OR = 1.54, 95% CI 1.49-1.59, P = 1.1 × 10-154) associated with a score of other non-HDL cholesterol variants predicting the same increase in non-HDL cholesterol (P for difference in effects = 2.4 × 10-4). CONCLUSIONS Genetic variation in cholesterol absorption affects levels of circulating non-HDL cholesterol and risk of CAD. Our results indicate that both dietary cholesterol and phytosterols contribute directly to atherogenesis.
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Affiliation(s)
- Anna Helgadottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland
| | | | | | - Vinicius Tragante
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland.,Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, the Netherlands
| | - Margret Thorsteinsdottir
- ArcticMass, Sturlugata 8, 102 Reykjavik, Iceland.,Faculty of Pharmaceutical Sciences, University of Iceland, Hofsvallagata 53, 107 Reykjavik, Iceland
| | | | | | - Eythór Björnsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland.,Department of Internal Medicine, Landspitali - National University Hospital of Iceland, 101 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmýrarvegur, 101 Reykjavik, Iceland
| | - Olafur Magnusson
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland
| | | | - Ingileif Jonsdottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmýrarvegur, 101 Reykjavik, Iceland
| | | | - Egil Ferkingstad
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland
| | | | | | - Isleifur Olafsson
- Department of Clinical Biochemistry, Landspitali -National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland
| | - Alex H Christensen
- Herlev-Gentofte Hospital, Copenhagen University Hospital, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology and Clinical Research, Nordsjaellands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark.,Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark
| | - Lars Køber
- The Capital Region's Unit of Inherited Cardiac Diseases, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Ole B Pedersen
- Department of Clinical Immunology, Næstved Hospital, Ringstedgade 61, 4700 Næstved, Denmark.,Department of Clinical Medicine, Copenhagen University, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Søren Brunak
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Karina Banasik
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Thomas F Hansen
- Translational Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.,Department of Neurology, Danish Headache Center, Glostrup, Rigshospitalet, Valdemar Hansens vej 1-23, 2600 Glostrup, Denmark.,Institute for Biological Psychiatry, Mental Health Center Sct. Hans, Boserupvej 2, 4000 Roskilde, Denmark
| | - Mette Nyegaard
- Department of Biomedicine, Aarhus University, Høegh-Guldbergs Gade 10, 8000 Aarhus, Denmark
| | | | - Olof Sigurdardottir
- Department of Clinical Biochemistry, Akureyri Hospital, Eyrarlandsvegur, 600 Akureyri, Iceland
| | - Bjorn L Thorarinsson
- Department of Neurology, Landspitali - National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland
| | | | - Thora Steingrimsdottir
- Faculty of Medicine, University of Iceland, Vatnsmýrarvegur, 101 Reykjavik, Iceland.,Department of Obstetrics and Gynecology, Landspitali - National University Hospital, Hringbraut, 101 Reykjavik, Iceland
| | - Einar S Bjornsson
- Department of Internal Medicine, Landspitali - National University Hospital of Iceland, 101 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmýrarvegur, 101 Reykjavik, Iceland
| | - Ragnar Danielsen
- Division of Cardiology, Department of Internal Medicine, Landspitali - National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, the Netherlands.,Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, Gower Street, London WC1E 6BT, UK.,Health Data Research UK and Institute of Health Informatics, University College London, Gower Street, London WC1E 6BT, UK
| | - David O Arnar
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmýrarvegur, 101 Reykjavik, Iceland.,Division of Cardiology, Department of Internal Medicine, Landspitali - National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland
| | - Henrik Ullum
- Department of Clinical Immunology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Henning Bundgaard
- The Capital Region's Unit of Inherited Cardiac Diseases, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Patrick Sulem
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland
| | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmýrarvegur, 101 Reykjavik, Iceland
| | - Gudmundur Thorgeirsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmýrarvegur, 101 Reykjavik, Iceland.,Division of Cardiology, Department of Internal Medicine, Landspitali - National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland.,School of Engineering and Natural Sciences, University of Iceland, Dunhagi, 101 Reykjavik, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen, Inc., Sturlugata 8, 102 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmýrarvegur, 101 Reykjavik, Iceland
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11
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Steinthorsdottir V, McGinnis R, Williams NO, Stefansdottir L, Thorleifsson G, Shooter S, Fadista J, Sigurdsson JK, Auro KM, Berezina G, Borges MC, Bumpstead S, Bybjerg-Grauholm J, Colgiu I, Dolby VA, Dudbridge F, Engel SM, Franklin CS, Frigge ML, Frisbaek Y, Geirsson RT, Geller F, Gretarsdottir S, Gudbjartsson DF, Harmon Q, Hougaard DM, Hegay T, Helgadottir A, Hjartardottir S, Jääskeläinen T, Johannsdottir H, Jonsdottir I, Juliusdottir T, Kalsheker N, Kasimov A, Kemp JP, Kivinen K, Klungsøyr K, Lee WK, Melbye M, Miedzybrodska Z, Moffett A, Najmutdinova D, Nishanova F, Olafsdottir T, Perola M, Pipkin FB, Poston L, Prescott G, Saevarsdottir S, Salimbayeva D, Scaife PJ, Skotte L, Staines-Urias E, Stefansson OA, Sørensen KM, Thomsen LCV, Tragante V, Trogstad L, Simpson NAB, Aripova T, Casas JP, Dominiczak AF, Walker JJ, Thorsteinsdottir U, Iversen AC, Feenstra B, Lawlor DA, Boyd HA, Magnus P, Laivuori H, Zakhidova N, Svyatova G, Stefansson K, Morgan L. Genetic predisposition to hypertension is associated with preeclampsia in European and Central Asian women. Nat Commun 2020; 11:5976. [PMID: 33239696 PMCID: PMC7688949 DOI: 10.1038/s41467-020-19733-6] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/26/2020] [Indexed: 12/21/2022] Open
Abstract
Preeclampsia is a serious complication of pregnancy, affecting both maternal and fetal health. In genome-wide association meta-analysis of European and Central Asian mothers, we identify sequence variants that associate with preeclampsia in the maternal genome at ZNF831/20q13 and FTO/16q12. These are previously established variants for blood pressure (BP) and the FTO variant has also been associated with body mass index (BMI). Further analysis of BP variants establishes that variants at MECOM/3q26, FGF5/4q21 and SH2B3/12q24 also associate with preeclampsia through the maternal genome. We further show that a polygenic risk score for hypertension associates with preeclampsia. However, comparison with gestational hypertension indicates that additional factors modify the risk of preeclampsia.
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Affiliation(s)
| | | | | | | | | | | | - João Fadista
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden
| | | | - Kirsi M Auro
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Galina Berezina
- Scientific Center of Obstetrics, Gynecology and Perinatology, Almaty, Kazakhstan
| | - Maria-Carolina Borges
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Jonas Bybjerg-Grauholm
- Department for Congenital Disorders, Danish Centre for Neonatal Screening, Statens Serum Institut, Copenhagen, Denmark
| | | | - Vivien A Dolby
- Leeds Institute of Medical Research (LIMR), School of Medicine, University of Leeds, Leeds, UK
| | - Frank Dudbridge
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Stephanie M Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Yr Frisbaek
- Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland
| | - Reynir T Geirsson
- Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland
| | - Frank Geller
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | | | - Daniel F Gudbjartsson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Quaker Harmon
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - David Michael Hougaard
- Department for Congenital Disorders, Danish Centre for Neonatal Screening, Statens Serum Institut, Copenhagen, Denmark
| | - Tatyana Hegay
- Institute of immunology and human genomics, Uzbek Academy of Sciences, Tashkent, Uzbekistan
| | | | - Sigrun Hjartardottir
- Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland
| | - Tiina Jääskeläinen
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Ingileif Jonsdottir
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Noor Kalsheker
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Abdumadjit Kasimov
- Institute of immunology and human genomics, Uzbek Academy of Sciences, Tashkent, Uzbekistan
| | - John P Kemp
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, QLD, Australia
| | - Katja Kivinen
- Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK
| | - Kari Klungsøyr
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Wai K Lee
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Mads Melbye
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Zosia Miedzybrodska
- Division of Applied Medicine, School of Medicine, Medical Sciences, Nutrition and Dentistry, University of Aberdeen, Aberdeen, UK
| | - Ashley Moffett
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Dilbar Najmutdinova
- Republic Specialized Scientific Practical Medical Centre of Obstetrics and Gynecology, Tashkent, Uzbekistan
| | - Firuza Nishanova
- Republic Specialized Scientific Practical Medical Centre of Obstetrics and Gynecology, Tashkent, Uzbekistan
| | - Thorunn Olafsdottir
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Markus Perola
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Lucilla Poston
- Department of Women and Children's Health, King's College London, London, UK
| | - Gordon Prescott
- Division of Applied Medicine, School of Medicine, Medical Sciences, Nutrition and Dentistry, University of Aberdeen, Aberdeen, UK
- Lancashire Clinical Trials Unit, University of Central Lancashire, Preston, UK
| | | | - Damilya Salimbayeva
- Scientific Center of Obstetrics, Gynecology and Perinatology, Almaty, Kazakhstan
| | | | - Line Skotte
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Eleonora Staines-Urias
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Liv Cecilie Vestrheim Thomsen
- Department of Clinical Science, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway
- Department of Clinical and Molecular Medicine, Centre of Molecular Inflammation Research (CEMIR), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Vinicius Tragante
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Lill Trogstad
- Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public Health, Oslo, Norway
| | - Nigel A B Simpson
- Division of Womens and Children's Health, School of Medicine, University of Leeds, Leeds, UK
| | - Tamara Aripova
- Institute of immunology and human genomics, Uzbek Academy of Sciences, Tashkent, Uzbekistan
| | - Juan P Casas
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anna F Dominiczak
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - James J Walker
- Leeds Institute of Medical Research (LIMR), School of Medicine, University of Leeds, Leeds, UK
| | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ann-Charlotte Iversen
- Department of Clinical and Molecular Medicine, Centre of Molecular Inflammation Research (CEMIR), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Bjarke Feenstra
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol NIHR Biomedical Research Centre, Bristol, UK
| | - Heather Allison Boyd
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Hannele Laivuori
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Nodira Zakhidova
- Institute of immunology and human genomics, Uzbek Academy of Sciences, Tashkent, Uzbekistan
| | - Gulnara Svyatova
- Scientific Center of Obstetrics, Gynecology and Perinatology, Almaty, Kazakhstan
| | - Kari Stefansson
- deCODE genetics/Amgen Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Linda Morgan
- School of Life Sciences, University of Nottingham, Nottingham, UK
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12
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Gudbjartsson DF, Thorgeirsson G, Sulem P, Helgadottir A, Gylfason A, Saemundsdottir J, Bjornsson E, Norddahl GL, Jonasdottir A, Jonasdottir A, Eggertsson HP, Gretarsdottir S, Thorleifsson G, Indridason OS, Palsson R, Jonasson F, Jonsdottir I, Eyjolfsson GI, Sigurdardottir O, Olafsson I, Danielsen R, Matthiasson SE, Kristmundsdottir S, Halldorsson BV, Hreidarsson AB, Valdimarsson EM, Gudnason T, Benediktsson R, Steinthorsdottir V, Thorsteinsdottir U, Holm H, Stefansson K. Lipoprotein(a) Concentration and Risks of Cardiovascular Disease and Diabetes. J Am Coll Cardiol 2019; 74:2982-2994. [PMID: 31865966 DOI: 10.1016/j.jacc.2019.10.019] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 09/05/2019] [Accepted: 10/06/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Lipoprotein(a) [Lp(a)] is a causal risk factor for cardiovascular diseases that has no established therapy. The attribute of Lp(a) that affects cardiovascular risk is not established. Low levels of Lp(a) have been associated with type 2 diabetes (T2D). OBJECTIVES This study investigated whether cardiovascular risk is conferred by Lp(a) molar concentration or apolipoprotein(a) [apo(a)] size, and whether the relationship between Lp(a) and T2D risk is causal. METHODS This was a case-control study of 143,087 Icelanders with genetic information, including 17,715 with coronary artery disease (CAD) and 8,734 with T2D. This study used measured and genetically imputed Lp(a) molar concentration, kringle IV type 2 (KIV-2) repeats (which determine apo(a) size), and a splice variant in LPA associated with small apo(a) but low Lp(a) molar concentration to disentangle the relationship between Lp(a) and cardiovascular risk. Loss-of-function homozygotes and other subjects genetically predicted to have low Lp(a) levels were evaluated to assess the relationship between Lp(a) and T2D. RESULTS Lp(a) molar concentration was associated dose-dependently with CAD risk, peripheral artery disease, aortic valve stenosis, heart failure, and lifespan. Lp(a) molar concentration fully explained the Lp(a) association with CAD, and there was no residual association with apo(a) size. Homozygous carriers of loss-of-function mutations had little or no Lp(a) and increased the risk of T2D. CONCLUSIONS Molar concentration is the attribute of Lp(a) that affects risk of cardiovascular diseases. Low Lp(a) concentration (bottom 10%) increases T2D risk. Pharmacologic reduction of Lp(a) concentration in the 20% of individuals with the greatest concentration down to the population median is predicted to decrease CAD risk without increasing T2D risk.
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Affiliation(s)
- Daniel F Gudbjartsson
- deCODE genetics/Amgen, Reykjavik, Iceland; School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Gudmundur Thorgeirsson
- deCODE genetics/Amgen, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Division of Cardiology and Cardiovascular Research Center, Internal Medicine Services, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | | | | | | | | | - Eythor Bjornsson
- deCODE genetics/Amgen, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | | | - Hannes P Eggertsson
- deCODE genetics/Amgen, Reykjavik, Iceland; School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | - Olafur S Indridason
- Division of Nephrology, Internal Medicine Services, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Runolfur Palsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Division of Nephrology, Internal Medicine Services, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Fridbert Jonasson
- deCODE genetics/Amgen, Reykjavik, Iceland; Department of Ophthalmology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Ingileif Jonsdottir
- deCODE genetics/Amgen, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Department of Immunology, Landspitali, The National University Hospital of Iceland
| | | | | | - Isleifur Olafsson
- Department of Clinical Biochemistry, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Ragnar Danielsen
- Division of Cardiology and Cardiovascular Research Center, Internal Medicine Services, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Snaedis Kristmundsdottir
- deCODE genetics/Amgen, Reykjavik, Iceland; School of Science and Engineering, Reykjavik University, Reykjavik, Iceland
| | - Bjarni V Halldorsson
- deCODE genetics/Amgen, Reykjavik, Iceland; School of Science and Engineering, Reykjavik University, Reykjavik, Iceland
| | - Astradur B Hreidarsson
- Division of Endocrinology and Metabolic Medicine, Internal Medicine Services, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Einar M Valdimarsson
- Department of Neurology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Thorarinn Gudnason
- Division of Cardiology and Cardiovascular Research Center, Internal Medicine Services, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Rafn Benediktsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Division of Endocrinology and Metabolic Medicine, Internal Medicine Services, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen, Reykjavik, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
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13
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Helgadottir A, Sulem P, Thorgeirsson G, Gretarsdottir S, Thorleifsson G, Jensson BÖ, Arnadottir GA, Olafsson I, Eyjolfsson GI, Sigurdardottir O, Thorsteinsdottir U, Gudbjartsson DF, Holm H, Stefansson K. Rare SCARB1 mutations associate with high-density lipoprotein cholesterol but not with coronary artery disease. Eur Heart J 2019; 39:2172-2178. [PMID: 29596577 PMCID: PMC6001888 DOI: 10.1093/eurheartj/ehy169] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 03/14/2018] [Indexed: 12/16/2022] Open
Abstract
Aims Scavenger receptor Class B Type 1 (SR-BI) is a major receptor for high-density lipoprotein (HDL) that promotes hepatic uptake of cholesterol from HDL. A rare mutation p.P376L, in the gene encoding SR-BI, SCARB1, was recently reported to associate with elevated HDL cholesterol (HDL-C) and increased risk of coronary artery disease (CAD), suggesting that increased HDL-C caused by SR-BI impairment might be an independent marker of cardiovascular risk. We tested the hypothesis that alleles in or close to SCARB1 that associate with elevated levels of HDL-C also associate with increased risk of CAD in the relatively homogeneous population of Iceland. Methods and results Using a large resource of whole-genome sequenced Icelanders, we identified thirteen SCARB1 coding mutations that we examined for association with HDL-C (n = 136 672). Three rare SCARB1 mutations, encoding p.G319V, p.V111M, and p.V32M (combined allelic frequency = 0.2%) associate with elevated levels of HDL-C (p.G319V: β = 11.1 mg/dL, P = 8.0 × 10−7; p.V111M: β = 8.3 mg/dL, P = 1.1 × 10−6; p.V32M: β = 10.2 mg/dL, P = 8.1 × 10−4). These mutations do not associate with CAD (36 886 cases/306 268 controls) (odds ratio = 0.90, 95% confidence interval 0.67–1.22, P = 0.49), despite effects on HDL-C comparable to that reported for p.P376L, both in terms of direction and magnitude. Furthermore, HDL-C raising alleles of three common SCARB1 non-coding variants, including one previously unreported (rs61941676-C: β = 1.25 mg/dL, P = 1.7 × 10−18), and of one low frequency coding variant (p.V135I) that independently associate with higher HDL-C, do not confer increased risk of CAD. Conclusion Elevated HDL-C due to genetically compromised SR-BI function is not a marker of CAD risk. ![]()
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Affiliation(s)
- Anna Helgadottir
- deCODE Genetics/Amgen, Inc., Sturlugata 8, 101 Reykjavik, Iceland
| | - Patrick Sulem
- deCODE Genetics/Amgen, Inc., Sturlugata 8, 101 Reykjavik, Iceland
| | - Gudmundur Thorgeirsson
- deCODE Genetics/Amgen, Inc., Sturlugata 8, 101 Reykjavik, Iceland.,Faculty of Medicine, Department of Medicine, University of Iceland, Saemundargata 2, 101 Reykjavik, Iceland.,Division of Cardiology, Department of Internal Medicine, Landspitali, National University Hospital of Iceland, Hringbraut, 101 Reykjavik, Iceland
| | | | | | | | | | - Isleifur Olafsson
- Department of Clinical Biochemistry, Landspitali, National University Hospital, Hringbraut, 101 Reykjavik, Iceland
| | | | - Olof Sigurdardottir
- Department of Clinical Biochemistry, Akureyri Hospital, 600 Akureyri, Iceland
| | - Unnur Thorsteinsdottir
- deCODE Genetics/Amgen, Inc., Sturlugata 8, 101 Reykjavik, Iceland.,Faculty of Medicine, Department of Medicine, University of Iceland, Saemundargata 2, 101 Reykjavik, Iceland
| | - Daniel F Gudbjartsson
- deCODE Genetics/Amgen, Inc., Sturlugata 8, 101 Reykjavik, Iceland.,School of Engineering and Natural Sciences, University of Iceland, 101 Reykjavik, Iceland
| | - Hilma Holm
- deCODE Genetics/Amgen, Inc., Sturlugata 8, 101 Reykjavik, Iceland
| | - Kari Stefansson
- deCODE Genetics/Amgen, Inc., Sturlugata 8, 101 Reykjavik, Iceland.,Faculty of Medicine, Department of Medicine, University of Iceland, Saemundargata 2, 101 Reykjavik, Iceland
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14
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Bjornsson T, Thorolfsdottir RB, Sveinbjornsson G, Sulem P, Norddahl GL, Helgadottir A, Gretarsdottir S, Magnusdottir A, Danielsen R, Sigurdsson EL, Adalsteinsdottir B, Gunnarsson SI, Jonsdottir I, Arnar DO, Helgason H, Gudbjartsson T, Gudbjartsson DF, Thorsteinsdottir U, Holm H, Stefansson K. A rare missense mutation in MYH6 associates with non-syndromic coarctation of the aorta. Eur Heart J 2019; 39:3243-3249. [PMID: 29590334 PMCID: PMC6127890 DOI: 10.1093/eurheartj/ehy142] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 03/02/2018] [Indexed: 12/13/2022] Open
Abstract
Aims Coarctation of the aorta (CoA) accounts for 4–8% of congenital heart defects (CHDs) and confers substantial morbidity despite treatment. It is increasingly recognized as a highly heritable condition. The aim of the study was to search for sequence variants that affect the risk of CoA. Methods and results We performed a genome-wide association study of CoA among Icelanders (120 cases and 355 166 controls) based on imputed variants identified through whole-genome sequencing. We found association with a rare (frequency = 0.34%) missense mutation p.Arg721Trp in MYH6 (odds ratio = 44.2, P = 5.0 × 10−22), encoding the alpha-heavy chain subunit of cardiac myosin, an essential sarcomere protein. Approximately 20% of individuals with CoA in Iceland carry this mutation. We show that p.Arg721Trp also associates with other CHDs, in particular bicuspid aortic valve. We have previously reported broad effects of p.Arg721Trp on cardiac electrical function and strong association with sick sinus syndrome and atrial fibrillation. Conclusion Through a population approach, we found that a rare missense mutation p.Arg721Trp in the sarcomere gene MYH6 has a strong effect on the risk of CoA and explains a substantial fraction of the Icelanders with CoA. This is the first mutation associated with non-familial or sporadic form of CoA at a population level. The p.Arg721Trp in MYH6 causes a cardiac syndrome with highly variable expressivity and emphasizes the importance of sarcomere integrity for cardiac development and function.
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Affiliation(s)
| | | | | | - Patrick Sulem
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik, Iceland
| | | | | | | | | | - Ragnar Danielsen
- Department of Medicine, Landspitali-The National University Hospital of Iceland, Hringbraut, Reykjavik, Iceland
| | - Emil L Sigurdsson
- Department of Family Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik, Iceland.,Department of Development, Primary Health Care of the Capital Area, Alfabakki 16, Reykjavik, Iceland
| | - Berglind Adalsteinsdottir
- Department of Cardiology, Haukeland University Hospital, Jonas Lies vei 83, Bergen, Norway.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik, Iceland
| | - Sverrir I Gunnarsson
- Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin, 600 Highland Ave, Madison, WI, USA
| | - Ingileif Jonsdottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik, Iceland.,Department of Immunology, Landspitali-The National University Hospital of Iceland, Hringbraut, Reykjavik, Iceland
| | - David O Arnar
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik, Iceland.,Department of Medicine, Landspitali-The National University Hospital of Iceland, Hringbraut, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik, Iceland
| | - Hrodmar Helgason
- Children's Hospital, Landspitali-The National University Hospital of Iceland, Hringbraut, Reykjavik, Iceland
| | - Tomas Gudbjartsson
- Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik, Iceland.,Department of Cardiothoracic Surgery, Landspitali-The National University Hospital of Iceland, Hringbraut, Reykjavik, Iceland
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik, Iceland.,School of Engineering and Natural Sciences, University of Iceland, Hjardarhagi 4, Reykjavik, Iceland
| | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen, Inc., Sturlugata 8, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, Reykjavik, Iceland
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Malik R, Chauhan G, Traylor M, Sargurupremraj M, Okada Y, Mishra A, Rutten-Jacobs L, Giese AK, van der Laan SW, Gretarsdottir S, Anderson CD, Chong M, Adams HHH, Ago T, Almgren P, Amouyel P, Ay H, Bartz TM, Benavente OR, Bevan S, Boncoraglio GB, Brown RD, Butterworth AS, Carrera C, Carty CL, Chasman DI, Chen WM, Cole JW, Correa A, Cotlarciuc I, Cruchaga C, Danesh J, de Bakker PIW, DeStefano AL, den Hoed M, Duan Q, Engelter ST, Falcone GJ, Gottesman RF, Grewal RP, Gudnason V, Gustafsson S, Haessler J, Harris TB, Hassan A, Havulinna AS, Heckbert SR, Holliday EG, Howard G, Hsu FC, Hyacinth HI, Ikram MA, Ingelsson E, Irvin MR, Jian X, Jiménez-Conde J, Johnson JA, Jukema JW, Kanai M, Keene KL, Kissela BM, Kleindorfer DO, Kooperberg C, Kubo M, Lange LA, Langefeld CD, Langenberg C, Launer LJ, Lee JM, Lemmens R, Leys D, Lewis CM, Lin WY, Lindgren AG, Lorentzen E, Magnusson PK, Maguire J, Manichaikul A, McArdle PF, Meschia JF, Mitchell BD, Mosley TH, Nalls MA, Ninomiya T, O'Donnell MJ, Psaty BM, Pulit SL, Rannikmäe K, Reiner AP, Rexrode KM, Rice K, Rich SS, Ridker PM, Rost NS, Rothwell PM, Rotter JI, Rundek T, Sacco RL, Sakaue S, Sale MM, Salomaa V, Sapkota BR, Schmidt R, Schmidt CO, Schminke U, Sharma P, Slowik A, Sudlow CLM, Tanislav C, Tatlisumak T, Taylor KD, Thijs VNS, Thorleifsson G, Thorsteinsdottir U, Tiedt S, Trompet S, Tzourio C, van Duijn CM, Walters M, Wareham NJ, Wassertheil-Smoller S, Wilson JG, Wiggins KL, Yang Q, Yusuf S, Bis JC, Pastinen T, Ruusalepp A, Schadt EE, Koplev S, Björkegren JLM, Codoni V, Civelek M, Smith NL, Trégouët DA, Christophersen IE, Roselli C, Lubitz SA, Ellinor PT, Tai ES, Kooner JS, Kato N, He J, van der Harst P, Elliott P, Chambers JC, Takeuchi F, Johnson AD, Sanghera DK, Melander O, Jern C, Strbian D, Fernandez-Cadenas I, Longstreth WT, Rolfs A, Hata J, Woo D, Rosand J, Pare G, Hopewell JC, Saleheen D, Stefansson K, Worrall BB, Kittner SJ, Seshadri S, Fornage M, Markus HS, Howson JMM, Kamatani Y, Debette S, Dichgans M. Publisher Correction: Multiancestry genome-wide association study of 520,000 subjects identifies 32 loci associated with stroke and stroke subtypes. Nat Genet 2019; 51:1192-1193. [PMID: 31160810 DOI: 10.1038/s41588-019-0449-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Ganesh Chauhan
- Centre for Brain Research, Indian Institute of Science, Bangalore, India
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Matthew Traylor
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Muralidharan Sargurupremraj
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France
| | - Yukinori Okada
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka, Japan
- Laboratory of Statistical Immunology, Immunology Frontier Research Center (WPI-IFReC), Osaka University, Suita, Japan
| | - Aniket Mishra
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France
| | - Loes Rutten-Jacobs
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Anne-Katrin Giese
- Department of Neurology, Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA
| | - Sander W van der Laan
- Laboratory of Experimental Cardiology, Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | | | - Christopher D Anderson
- Center for Genomic Medicine, MGH, Boston, MA, USA
- J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Michael Chong
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Hieab H H Adams
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Tetsuro Ago
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Peter Almgren
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Philippe Amouyel
- INSERM, Institut Pasteur de Lille, LabEx DISTALZ-UMR1167, Risk Factors and Molecular Determinants of Aging-Related Diseases, Université Lille, Lille, France
- Centre Hospitalier Université Lille, Epidemiology and Public Health Department, Lille, France
| | - Hakan Ay
- J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA
- AA Martinos Center for Biomedical Imaging, Department of Radiology, MGH, Harvard Medical School, Boston, MA, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, Seattle, WA, USA
| | - Oscar R Benavente
- Division of Neurology, Faculty of Medicine, Brain Research Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Steve Bevan
- School of Life Science, University of Lincoln, Lincoln, UK
| | - Giorgio B Boncoraglio
- Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico 'Carlo Besta', Milan, Italy
| | - Robert D Brown
- Department of Neurology, Mayo Clinic Rochester, Rochester, MN, USA
| | - Adam S Butterworth
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
| | - Caty Carrera
- Neurovascular Research Laboratory, Vall d'Hebron Institut of Research, Neurology and Medicine Departments-Universitat Autònoma de Barcelona, Vall d'Hebrón Hospital, Barcelona, Spain
- Stroke Pharmacogenomics and Genetics, Fundacio Docència i Recerca MutuaTerrassa, Terrassa, Spain
| | - Cara L Carty
- Children's Research Institute, Children's National Medical Center, Washington, DC, USA
- Center for Translational Science, George Washington University, Washington, DC, USA
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Wei-Min Chen
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - John W Cole
- Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD, USA
| | - Adolfo Correa
- Departments of Medicine, Pediatrics and Population Health Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Ioana Cotlarciuc
- Institute of Cardiovascular Research, Royal Holloway University of London, London, UK, and Ashford and St Peters Hospital, Surrey, UK
| | - Carlos Cruchaga
- Department of Psychiatry, Hope Center Program on Protein Aggregation and Neurodegeneration (HPAN), Washington University School of Medicine, St. Louis, MO, USA
- Department of Developmental Biology, Washington University School of Medicine, St. Louis, MO, USA
| | - John Danesh
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
- British Heart Foundation, Cambridge Centre of Excellence, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Paul I W de Bakker
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anita L DeStefano
- Boston University School of Public Health, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Marcel den Hoed
- Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Qing Duan
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Stefan T Engelter
- Department of Neurology and Stroke Center, Basel University Hospital, Basel, Switzerland
- Neurorehabilitation Unit, University of Basel and University Center for Medicine of Aging and Rehabilitation Basel, Felix Platter Hospital, Basel, Switzerland
| | - Guido J Falcone
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Rebecca F Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Raji P Grewal
- Neuroscience Institute, SF Medical Center, Trenton, NJ, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association Research Institute, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Stefan Gustafsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Jeffrey Haessler
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Ahamad Hassan
- Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Aki S Havulinna
- National Institute for Health and Welfare, Helsinki, Finland
- FIMM-Institute for Molecular Medicine Finland, Helsinki, Finland
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Elizabeth G Holliday
- Public Health Stream, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - George Howard
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Fang-Chi Hsu
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hyacinth I Hyacinth
- Aflac Cancer and Blood Disorder Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Erik Ingelsson
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Marguerite R Irvin
- Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Xueqiu Jian
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jordi Jiménez-Conde
- Neurovascular Research Group (NEUVAS), Neurology Department, Institut Hospital del Mar d'Investigació Mèdica, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Julie A Johnson
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, College of Pharmacy, Gainesville, FL, USA
- Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Masahiro Kanai
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka, Japan
- Program in Bioinformatics and Integrative Genomics, Harvard Medical School, Boston, MA, USA
| | - Keith L Keene
- Department of Biology, East Carolina University, Greenville, NC, USA
- Center for Health Disparities, East Carolina University, Greenville, NC, USA
| | - Brett M Kissela
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Leslie A Lange
- Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Carl D Langefeld
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - Lenore J Launer
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Jin-Moo Lee
- Department of Neurology, Radiology, and Biomedical Engineering, Washington University School of Medicine, St. Louis, MO, USA
| | - Robin Lemmens
- Department of Neurosciences, Experimental Neurology, KU Leuven-University of Leuven, Leuven, Belgium
- VIB Center for Brain & Disease Research, University Hospitals Leuven, Department of Neurology, Leuven, Belgium
| | - Didier Leys
- INSERM U 1171, CHU Lille, Université Lille, Lille, France
| | - Cathryn M Lewis
- Department of Medical and Molecular Genetics, King's College London, London, UK
- SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Wei-Yu Lin
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Northern Institute for Cancer Research, Newcastle University, Newcastle, UK
| | - Arne G Lindgren
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Erik Lorentzen
- Bioinformatics Core Facility, University of Gothenburg, Gothenburg, Sweden
| | - Patrik K Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jane Maguire
- University of Technology Sydney, Faculty of Health, Ultimo, New South Wales, Australia
| | - Ani Manichaikul
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Patrick F McArdle
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Braxton D Mitchell
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Thomas H Mosley
- Division of Geriatrics, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
- Memory Impairment and Neurodegenerative Dementia Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - Michael A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Data Tecnica International, Glen Echo, MD, USA
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Martin J O'Donnell
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Clinical Research Facility, Department of Medicine, NUI Galway, Galway, Ireland
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Sara L Pulit
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
- Brain Center Rudolf Magnus, Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Kristiina Rannikmäe
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Alexander P Reiner
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
| | - Kathryn M Rexrode
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Stephen S Rich
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Paul M Ridker
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Natalia S Rost
- Department of Neurology, Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA
- J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA
| | - Peter M Rothwell
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
- Division of Genomic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Saori Sakaue
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Michele M Sale
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Bishwa R Sapkota
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Carsten O Schmidt
- Institute for Community Medicine, SHIP-KEF, University Medicine Greifswald, Greifswald, Germany
| | - Ulf Schminke
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London, London, UK, and Ashford and St Peters Hospital, Surrey, UK
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University, Krakow, Poland
| | - Cathie L M Sudlow
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Turgut Tatlisumak
- Department of Clinical Neurosciences/Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kent D Taylor
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
- Division of Genomic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Vincent N S Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia
- Austin Health, Department of Neurology, Heidelberg, Victoria, Australia
| | | | | | - Steffen Tiedt
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Stella Trompet
- Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Christophe Tzourio
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- INSERM, U1219, Bordeaux, France
- Department of Public Health, Bordeaux University Hospital, Bordeaux, France
| | - Cornelia M van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Center for Medical Systems Biology, Leiden, the Netherlands
| | - Matthew Walters
- School of Medicine, Dentistry and Nursing at the University of Glasgow, Glasgow, UK
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - James G Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kerri L Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Qiong Yang
- Boston University School of Public Health, Boston, MA, USA
| | - Salim Yusuf
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Tomi Pastinen
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Arno Ruusalepp
- Department of Pathophysiology, Institute of Biomedicine and Translation Medicine, University of Tartu, Tartu, Estonia
- Department of Cardiac Surgery, Tartu University Hospital, Tartu, Estonia
- Clinical Gene Networks AB, Stockholm, Sweden
| | - Eric E Schadt
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Simon Koplev
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Johan L M Björkegren
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pathophysiology, Institute of Biomedicine and Translation Medicine, Biomeedikum, University of Tartu, Tartu, Estonia
- Integrated Cardio Metabolic Centre, Department of Medicine, Karolinska Institutet, Karolinska Universitetssjukhuset, Huddinge, Sweden
- Clinical Gene Networks AB, Stockholm, Sweden
| | - Veronica Codoni
- UPMC Univ. Paris 06, INSERM, UMR_S 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, Sorbonne Universités, Paris, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Mete Civelek
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Nicholas L Smith
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA
- Seattle Epidemiologic Research and Information Center, VA Office of Research and Development, Seattle, WA, USA
| | - David A Trégouët
- UPMC Univ. Paris 06, INSERM, UMR_S 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, Sorbonne Universités, Paris, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Ingrid E Christophersen
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Cardiovascular Research Center, MGH, Boston, MA, USA
- Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway
| | - Carolina Roselli
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Steven A Lubitz
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Cardiovascular Research Center, MGH, Boston, MA, USA
| | - Patrick T Ellinor
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Cardiovascular Research Center, MGH, Boston, MA, USA
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Jaspal S Kooner
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Norihiro Kato
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Pim van der Harst
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Paul Elliott
- MRC-PHE Centre for Environment and Health, School of Public Health, Department of Epidemiology and Biostatistics and the NIHR Imperial Biomedical Research Centre, Imperial College London, London, UK
| | - John C Chambers
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Department of Cardiology, Ealing Hospital NHS Trust, Southall, UK
| | - Fumihiko Takeuchi
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Andrew D Johnson
- Framingham Heart Study, Framingham, MA, USA
- National Heart, Lung and Blood Research Institute, Division of Intramural Research, Population Sciences Branch, Framingham, MA, USA
| | - Dharambir K Sanghera
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Neuroscience, Oklahoma City, OK, USA
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Christina Jern
- Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Daniel Strbian
- Department of Neurology, Helsinki University Hospital, Helsinki, Finland
- Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, Finland
| | - Israel Fernandez-Cadenas
- Neurovascular Research Laboratory, Vall d'Hebron Institut of Research, Neurology and Medicine Departments-Universitat Autònoma de Barcelona, Vall d'Hebrón Hospital, Barcelona, Spain
- Stroke Pharmacogenomics and Genetics, Fundacio Docència i Recerca MutuaTerrassa, Terrassa, Spain
| | - W T Longstreth
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Arndt Rolfs
- Albrecht Kossel Institute, University Clinic of Rostock, Rostock, Germany
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daniel Woo
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jonathan Rosand
- Center for Genomic Medicine, MGH, Boston, MA, USA
- J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Guillaume Pare
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Jemma C Hopewell
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Danish Saleheen
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kari Stefansson
- deCODE genetics/AMGEN Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Bradford B Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Steven J Kittner
- Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD, USA
| | - Sudha Seshadri
- Framingham Heart Study, Framingham, MA, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, San Antonio, TX, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
- Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hugh S Markus
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Joanna M M Howson
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Stephanie Debette
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France.
- Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France.
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
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16
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Ferkingstad E, Oddsson A, Gretarsdottir S, Benonisdottir S, Thorleifsson G, Deaton AM, Jonsson S, Stefansson OA, Norddahl GL, Zink F, Arnadottir GA, Gunnarsson B, Halldorsson GH, Helgadottir A, Jensson BO, Kristjansson RP, Sveinbjornsson G, Sverrisson DA, Masson G, Olafsson I, Eyjolfsson GI, Sigurdardottir O, Holm H, Jonsdottir I, Olafsson S, Steingrimsdottir T, Rafnar T, Bjornsson ES, Thorsteinsdottir U, Gudbjartsson DF, Sulem P, Stefansson K. Genome-wide association meta-analysis yields 20 loci associated with gallstone disease. Nat Commun 2018; 9:5101. [PMID: 30504769 PMCID: PMC6269469 DOI: 10.1038/s41467-018-07460-y] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 11/01/2018] [Indexed: 01/07/2023] Open
Abstract
Gallstones are responsible for one of the most common diseases in the Western world and are commonly treated with cholecystectomy. We perform a meta-analysis of two genome-wide association studies of gallstone disease in Iceland and the UK, totaling 27,174 cases and 736,838 controls, uncovering 21 novel gallstone-associated variants at 20 loci. Two distinct low frequency missense variants in SLC10A2, encoding the apical sodium-dependent bile acid transporter (ASBT), associate with an increased risk of gallstone disease (Pro290Ser: OR = 1.36 [1.25-1.49], P = 2.1 × 10-12, MAF = 1%; Val98Ile: OR = 1.15 [1.10-1.20], P = 1.8 × 10-10, MAF = 4%). We demonstrate that lower bile acid transport by ASBT is accompanied by greater risk of gallstone disease and highlight the role of the intestinal compartment of the enterohepatic circulation of bile acids in gallstone disease susceptibility. Additionally, two low frequency missense variants in SERPINA1 and HNF4A and 17 common variants represent novel associations with gallstone disease.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Florian Zink
- deCODE Genetics/Amgen, Inc., Reykjavik, 101, Iceland
| | | | | | | | | | | | | | | | | | - Gisli Masson
- deCODE Genetics/Amgen, Inc., Reykjavik, 101, Iceland
| | - Isleifur Olafsson
- Department of Clinical Biochemistry, Landspítali University Hospital, Reykjavik, 101, Iceland
| | | | - Olof Sigurdardottir
- Department of Clinical Biochemistry, Akureyri Hospital, Akureyri, 600, Iceland
| | - Hilma Holm
- deCODE Genetics/Amgen, Inc., Reykjavik, 101, Iceland
| | - Ingileif Jonsdottir
- deCODE Genetics/Amgen, Inc., Reykjavik, 101, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
- Department of Immunology, Landspitali University Hospital, Reykjavik, 101, Iceland
| | - Sigurdur Olafsson
- Department of Internal Medicine, Landspitali University Hospital, Reykjavik, 101, Iceland
| | - Thora Steingrimsdottir
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
- Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, 101, Iceland
| | | | - Einar S Bjornsson
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
- Department of Internal Medicine, Landspitali University Hospital, Reykjavik, 101, Iceland
| | - Unnur Thorsteinsdottir
- deCODE Genetics/Amgen, Inc., Reykjavik, 101, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | - Daniel F Gudbjartsson
- deCODE Genetics/Amgen, Inc., Reykjavik, 101, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, 101, Iceland
| | - Patrick Sulem
- deCODE Genetics/Amgen, Inc., Reykjavik, 101, Iceland.
| | - Kari Stefansson
- deCODE Genetics/Amgen, Inc., Reykjavik, 101, Iceland.
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland.
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17
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Thorolfsdottir RB, Sveinbjornsson G, Sulem P, Nielsen JB, Jonsson S, Halldorsson GH, Melsted P, Ivarsdottir EV, Davidsson OB, Kristjansson RP, Thorleifsson G, Helgadottir A, Gretarsdottir S, Norddahl G, Rajamani S, Torfason B, Valgardsson AS, Sverrisson JT, Tragante V, Holmen OL, Asselbergs FW, Roden DM, Darbar D, Pedersen TR, Sabatine MS, Willer CJ, Løchen ML, Halldorsson BV, Jonsdottir I, Hveem K, Arnar DO, Thorsteinsdottir U, Gudbjartsson DF, Holm H, Stefansson K. Coding variants in RPL3L and MYZAP increase risk of atrial fibrillation. Commun Biol 2018; 1:68. [PMID: 30271950 PMCID: PMC6123807 DOI: 10.1038/s42003-018-0068-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 05/11/2018] [Indexed: 12/29/2022] Open
Abstract
Most sequence variants identified hitherto in genome-wide association studies (GWAS) of atrial fibrillation are common, non-coding variants associated with risk through unknown mechanisms. We performed a meta-analysis of GWAS of atrial fibrillation among 29,502 cases and 767,760 controls from Iceland and the UK Biobank with follow-up in samples from Norway and the US, focusing on low-frequency coding and splice variants aiming to identify causal genes. We observe associations with one missense (OR = 1.20) and one splice-donor variant (OR = 1.50) in RPL3L, the first ribosomal gene implicated in atrial fibrillation to our knowledge. Analysis of 167 RNA samples from the right atrium reveals that the splice-donor variant in RPL3L results in exon skipping. We also observe an association with a missense variant in MYZAP (OR = 1.38), encoding a component of the intercalated discs of cardiomyocytes. Both discoveries emphasize the close relationship between the mechanical and electrical function of the heart.
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Affiliation(s)
- Rosa B Thorolfsdottir
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | | | - Jonas B Nielsen
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Pall Melsted
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | | | | | | | | | | | | | - Bjarni Torfason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland
| | - Atli S Valgardsson
- Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland
| | - Jon T Sverrisson
- Department of Medicine, Akureyri Regional Hospital, Akureyri, Iceland
| | - Vinicius Tragante
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Oddgeir L Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Cardiology, St. Olav's University Hospital, Trondheim, Norway
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
- Durrer Center for Cardiovascular Research, Netherlands Heart Institute, Utrecht, The Netherlands
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
- Farr Institute of Health Informatics Research and Institute of Health Informatics, University College London, London, UK
| | - Dan M Roden
- Departments of Medicine, Pharmacology, and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dawood Darbar
- Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Terje R Pedersen
- Center For Preventive Medicine, Oslo University Hospital and Medical Faculty, University of Oslo, Oslo, Norway
| | - Marc S Sabatine
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Cristen J Willer
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjarni V Halldorsson
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- Reykjavik University, Reykjavik, Iceland
| | - Ingileif Jonsdottir
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of immunology, Landspitali University Hospital, Reykjavik, Iceland
| | - Kristian Hveem
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - David O Arnar
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland.
| | - Kari Stefansson
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland.
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
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18
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Malik R, Chauhan G, Traylor M, Sargurupremraj M, Okada Y, Mishra A, Rutten-Jacobs L, Giese AK, van der Laan SW, Gretarsdottir S, Anderson CD, Chong M, Adams HHH, Ago T, Almgren P, Amouyel P, Ay H, Bartz TM, Benavente OR, Bevan S, Boncoraglio GB, Brown RD, Butterworth AS, Carrera C, Carty CL, Chasman DI, Chen WM, Cole JW, Correa A, Cotlarciuc I, Cruchaga C, Danesh J, de Bakker PIW, DeStefano AL, den Hoed M, Duan Q, Engelter ST, Falcone GJ, Gottesman RF, Grewal RP, Gudnason V, Gustafsson S, Haessler J, Harris TB, Hassan A, Havulinna AS, Heckbert SR, Holliday EG, Howard G, Hsu FC, Hyacinth HI, Ikram MA, ingelsson E, Irvin MR, Jian X, Jimenez-Conde J, Johnson JA, Jukema JW, Kanai M, Keene KL, Kissela BM, Kleindorfer DO, Kooperberg C, Kubo M, Lange LA, Langefeld CD, Langenberg C, Launer LJ, Lee JM, Lemmens R, Leys D, Lewis CM, Lin WY, Lindgren AG, Lorentzen E, Magnusson PK, Maguire J, Manichaikul A, McArdle PF, Meschia JF, Mitchell BD, Mosley TH, Nalls MA, Ninomiya T, O’Donnell MJ, Psaty BM, Pulit SL, Rannikmäe K, Reiner AP, Rexrode KM, Rice K, Rich SS, Ridker PM, Rost NS, Rothwell PM, Rotter JI, Rundek T, Sacco RL, Sakaue S, Sale MM, Salomaa V, Sapkota BR, Schmidt R, Schmidt CO, Schminke U, Sharma P, Slowik A, Sudlow CLM, Tanislav C, Tatlisumak T, Taylor KD, Thijs VNS, Thorleifsson G, Thorsteinsdottir U, Tiedt S, Trompet S, Tzourio C, van Duijn CM, Walters M, Wareham NJ, Wassertheil-Smoller S, Wilson JG, Wiggins KL, Yang Q, Yusuf S, Bis JC, Pastinen T, Ruusalepp A, Schadt EE, Koplev S, Björkegren JLM, Codoni V, Civelek M, Smith NL, Tregouet DA, Christophersen IE, Roselli C, Lubitz SA, Ellinor PT, Tai ES, Kooner JS, Kato N, He J, van der Harst P, Elliott P, Chambers JC, Takeuchi F, Johnson AD, Sanghera DK, Melander O, Jern C, Strbian D, Fernandez-Cadenas I, Longstreth WT, Rolfs A, Hata J, Woo D, Rosand J, Pare G, Hopewell JC, Saleheen D, Stefansson K, Worrall BB, Kittner SJ, Seshadri S, Fornage M, Markus HS, Howson JMM, Kamatani Y, Debette S, Dichgans M. Multiancestry genome-wide association study of 520,000 subjects identifies 32 loci associated with stroke and stroke subtypes. Nat Genet 2018; 50:524-537. [PMID: 29531354 PMCID: PMC5968830 DOI: 10.1038/s41588-018-0058-3] [Citation(s) in RCA: 865] [Impact Index Per Article: 144.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 01/08/2018] [Indexed: 02/02/2023]
Abstract
Stroke has multiple etiologies, but the underlying genes and pathways are largely unknown. We conducted a multiancestry genome-wide-association meta-analysis in 521,612 individuals (67,162 cases and 454,450 controls) and discovered 22 new stroke risk loci, bringing the total to 32. We further found shared genetic variation with related vascular traits, including blood pressure, cardiac traits, and venous thromboembolism, at individual loci (n = 18), and using genetic risk scores and linkage-disequilibrium-score regression. Several loci exhibited distinct association and pleiotropy patterns for etiological stroke subtypes. Eleven new susceptibility loci indicate mechanisms not previously implicated in stroke pathophysiology, with prioritization of risk variants and genes accomplished through bioinformatics analyses using extensive functional datasets. Stroke risk loci were significantly enriched in drug targets for antithrombotic therapy.
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Affiliation(s)
- Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Ganesh Chauhan
- Centre for Brain Research, Indian Institute of Science, Bangalore, India,INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, France
| | - Matthew Traylor
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Muralidharan Sargurupremraj
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, France,Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France
| | - Yukinori Okada
- Laboratory of Statistical Immunology, Immunology Frontier Research Center (WPI-IFReC), Osaka University, Suita, Japan,Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Aniket Mishra
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, France,Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France
| | - Loes Rutten-Jacobs
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Anne-Katrin Giese
- Department of Neurology, Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA
| | - Sander W. van der Laan
- Laboratory of Experimental Cardiology, Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | | | - Christopher D. Anderson
- Center for Genomic Medicine, MGH, Boston, MA, USA,J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Michael Chong
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Hieab H. H. Adams
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Tetsuro Ago
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Peter Almgren
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Philippe Amouyel
- INSERM, Institut Pasteur de Lille, LabEx DISTALZ-UMR1167, Risk Factors and Molecular Determinants of Aging-Related Diseases, Université Lille, Lille, France,Centre Hospitalier Universite Lille, Epidemiology and Public Health Department, Lille, France
| | - Hakan Ay
- J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA,AA Martinos Center for Biomedical Imaging, Department of Radiology, MGH, Harvard Medical School, Boston, MA, USA
| | - Traci M. Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, Seattle, WA, USA
| | - Oscar R. Benavente
- Division of Neurology, Faculty of Medicine, Brain Research Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Steve Bevan
- School of Life Science, University of Lincoln, Lincoln, UK
| | - Giorgio B. Boncoraglio
- Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico ‘Carlo Besta’, Milan, Italy
| | - Robert D. Brown
- Department of Neurology, Mayo Clinic Rochester, Rochester, MN, USA
| | - Adam S. Butterworth
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK,National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
| | - Caty Carrera
- Neurovascular Research Laboratory, Vall d’Hebron Institut of Research, Neurology and Medicine Departments-Universitat Autònoma de Barcelona, Vall d’Hebrón Hospital, Barcelona, Spain,Stroke Pharmacogenomics and Genetics, Fundacio Docència i Recerca MutuaTerrassa, Terrassa, Spain
| | - Cara L. Carty
- Children’s Research Institute, Children’s National Medical Center, Washington, DC, USA,Center for Translational Science, George Washington University, Washington, DC, USA
| | - Daniel I. Chasman
- Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Wei-Min Chen
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - John W. Cole
- Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD, USA
| | - Adolfo Correa
- Departments of Medicine, Pediatrics and Population Health Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Ioana Cotlarciuc
- Institute of Cardiovascular Research, Royal Holloway University of London, London, UK, and Ashford and St Peters Hospital, Surrey, UK
| | - Carlos Cruchaga
- Department of Psychiatry, Hope Center Program on Protein Aggregation and Neurodegeneration (HPAN), Washington University School of Medicine, St. Louis, MO, USA,Department of Developmental Biology, Washington University School of Medicine, St. Louis, MO, USA
| | - John Danesh
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK,NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK,Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK,British Heart Foundation, Cambridge Centre of Excellence, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Paul I. W. de Bakker
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands,Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anita L. DeStefano
- Boston University School of Public Health, Boston, MA, USA,Framingham Heart Study, Framingham, MA, USA
| | - Marcel den Hoed
- Department of Immunology, Genetics and Pathology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Qing Duan
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Stefan T. Engelter
- Department of Neurology and Stroke Center, Basel University Hospital, Basel, Switzerland,Neurorehabilitation Unit, University of Basel and University Center for Medicine of Aging and Rehabilitation Basel, Felix Platter Hospital, Basel, Switzerland
| | - Guido J. Falcone
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Rebecca F. Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Raji P. Grewal
- Neuroscience Institute, SF Medical Center, Trenton, NJ, USA
| | - Vilmundur Gudnason
- Icelandic Heart Association Research Institute, Kopavogur, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Stefan Gustafsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Jeffrey Haessler
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Tamara B. Harris
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Ahamad Hassan
- Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Aki S. Havulinna
- National Institute for Health and Welfare, Helsinki, Finland,FIMM-Institute for Molecular Medicine Finland, Helsinki, Finland
| | - Susan R. Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Elizabeth G. Holliday
- Public Health Stream, Hunter Medical Research Institute, New Lambton, New South Wales, Australia,Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - George Howard
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Fang-Chi Hsu
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hyacinth I. Hyacinth
- Aflac Cancer and Blood Disorder Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Erik ingelsson
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA,Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Marguerite R. Irvin
- Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Xueqiu Jian
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jordi Jimenez-Conde
- Neurovascular Research Group (NEUVAS), Neurology Department, Institut Hospital del Mar d’Investigació Mèdica, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Julie A. Johnson
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, College of Pharmacy, Gainesville, FL, USA,Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - J. Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Masahiro Kanai
- Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia,Program in Bioinformatics and Integrative Genomics, Harvard Medical School, Boston, MA, USA
| | - Keith L. Keene
- Department of Biology, East Carolina University, Greenville, NC, USA,Center for Health Disparities, East Carolina University, Greenville, NC, USA
| | - Brett M. Kissela
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Leslie A. Lange
- Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Carl D. Langefeld
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - Lenore J. Launer
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Jin-Moo Lee
- Department of Neurology, Radiology, and Biomedical Engineering, Washington University School of Medicine, St. Louis, MO, USA
| | - Robin Lemmens
- Department of Neurosciences, Experimental Neurology, KU Leuven-University of Leuven, Leuven, Belgium,VIB Center for Brain & Disease Research, University Hospitals Leuven, Department of Neurology, Leuven, Belgium
| | - Didier Leys
- INSERM U 1171, CHU Lille, Universite Lille, Lille, France
| | - Cathryn M. Lewis
- Department of Medical and Molecular Genetics, King’s College London, London, UK,SGDP Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Wei-Yu Lin
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK,Northern Institute for Cancer Research, Newcastle University, Newcastle, UK
| | - Arne G. Lindgren
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Erik Lorentzen
- Bioinformatics Core Facility, University of Gothenburg, Gothenburg, Sweden
| | - Patrik K. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jane Maguire
- University of Technology Sydney, Faculty of Health, Ultimo, New South Wales, Australia
| | - Ani Manichaikul
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Patrick F. McArdle
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Braxton D. Mitchell
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA,Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Thomas H. Mosley
- Division of Geriatrics, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA,Memory Impairment and Neurodegenerative Dementia Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - Michael A. Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA,Data Tecnica International, Glen Echo, MD, USA
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Martin J. O’Donnell
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada,Clinical Research Facility, Department of Medicine, NUI Galway, Galway, Ireland
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA,Department of Epidemiology, University of Washington, Seattle, WA, USA,Department of Health Services, University of Washington, Seattle, WA, USA,Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Sara L. Pulit
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands,Brain Center Rudolf Magnus, Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Kristiina Rannikmäe
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Alexander P. Reiner
- Department of Epidemiology, University of Washington, Seattle, WA, USA,Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
| | | | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Stephen S. Rich
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Paul M. Ridker
- Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Natalia S. Rost
- Department of Neurology, Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA,J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA
| | - Peter M. Rothwell
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA,Division of Genomic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ralph L. Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Saori Sakaue
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka, Japan,Department of Allergy and Rheumatology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Michele M. Sale
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Bishwa R. Sapkota
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Carsten O. Schmidt
- Institute for Community Medicine, SHIP-KEF, University Medicine Greifswald, Greifswald, Germany
| | - Ulf Schminke
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London, London, UK, and Ashford and St Peters Hospital, Surrey, UK
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University, Krakow, Poland
| | - Cathie L. M. Sudlow
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Turgut Tatlisumak
- Department of Clinical Neurosciences/Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden,Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kent D. Taylor
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA,Division of Genomic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Vincent N. S. Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia,Austin Health, Department of Neurology, Heidelberg, Victoria, Australia
| | | | | | - Steffen Tiedt
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Stella Trompet
- Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Christophe Tzourio
- INSERM U1219 Bordeaux Population Health Research Center, University of Bordeaux, France,INSERM, U1219 Bordeaux, France,Department of Public Health, Bordeaux University Hospital, Bordeaux, France
| | - Cornelia M. van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands,Center for Medical Systems Biology, Leiden, the Netherlands
| | - Matthew Walters
- School of Medicine, Dentistry and Nursing at the University of Glasgow, Glasgow, UK
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - James G. Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kerri L. Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Qiong Yang
- Boston University School of Public Health, Boston, MA, USA
| | - Salim Yusuf
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - AFGen Consortium
- A list of members and affiliations appears in the Supplementary Note
| | | | | | - INVENT Consortium
- A list of members and affiliations appears in the Supplementary Note
| | - STARNET
- A list of members and affiliations appears in the Supplementary Note
| | - Joshua C. Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Tomi Pastinen
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Arno Ruusalepp
- Department of Pathophysiology, Institute of Biomedicine and Translation Medicine, University of Tartu, Tartu, Estonia,Department of Cardiac Surgery, Tartu University Hospital, Tartu, Estonia,Clinical Gene Networks AB, Stockholm, Sweden
| | - Eric E. Schadt
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Simon Koplev
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Johan L. M. Björkegren
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology Icahn School of Medicine at Mount Sinai, New York, NY, USA,Department of Pathophysiology, Institute of Biomedicine and Translation Medicine, Biomeedikum, University of Tartu, Tartu, Estonia,Integrated Cardio Metabolic Centre, Department of Medicine, Karolinska Institutet, Karolinska Universitetssjukhuset, Huddinge, Sweden,Clinical Gene Networks AB, Stockholm, Sweden
| | - Veronica Codoni
- UPMC Univ. Paris 06, INSERM, UMR_S 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, Sorbonne Universités, Paris, France,I CAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Mete Civelek
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA,Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
| | - Nicholas L. Smith
- Department of Epidemiology, University of Washington, Seattle, WA, USA,Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA,Seattle Epidemiologic Research and Information Center, VA Office of Research and Development, Seattle, WA, USA
| | - David A. Tregouet
- UPMC Univ. Paris 06, INSERM, UMR_S 1166, Team Genomics & Pathophysiology of Cardiovascular Diseases, Sorbonne Universités, Paris, France,I CAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Ingrid E. Christophersen
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA,Cardiovascular Research Center, MGH, Boston, MA, USA,Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway
| | - Carolina Roselli
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Steven A. Lubitz
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA,Cardiovascular Research Center, MGH, Boston, MA, USA
| | - Patrick T. Ellinor
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA,Cardiovascular Research Center, MGH, Boston, MA, USA
| | - E. Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Jaspal S. Kooner
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Norihiro Kato
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Pim van der Harst
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Paul Elliott
- MRC-PHE Centre for Environment and Health, School of Public Health, Department of Epidemiology and Biostatistics and the NIHR Imperial Biomedical Research Centre, Imperial College London, London, UK
| | - John C. Chambers
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK,Department of Cardiology, Ealing Hospital NHS Trust, Southall, UK
| | - Fumihiko Takeuchi
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Andrew D. Johnson
- Framingham Heart Study, Framingham, MA, USA,National Heart, Lung and Blood Research Institute, Division of Intramural Research, Population Sciences Branch, Framingham, MA, USA
| | | | | | | | | | | | | | | | | | | | | | - Dharambir K. Sanghera
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA,Department of Pharmaceutical Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA,Oklahoma Center for Neuroscience, Oklahoma City, OK, USA
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Christina Jern
- Department of Pathology and Genetics, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Daniel Strbian
- Department of Neurology, Helsinki University Hospital, Helsinki, Finland,Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, Finland
| | - Israel Fernandez-Cadenas
- Neurovascular Research Laboratory, Vall d’Hebron Institut of Research, Neurology and Medicine Departments-Universitat Autònoma de Barcelona, Vall d’Hebrón Hospital, Barcelona, Spain,Stroke Pharmacogenomics and Genetics, Fundacio Docència i Recerca MutuaTerrassa, Terrassa, Spain
| | - W. T. Longstreth
- Department of Epidemiology, University of Washington, Seattle, WA, USA,Department of Neurology, University of Washington, Seattle, WA, USA
| | - Arndt Rolfs
- Albrecht Kossel Institute, University Clinic of Rostock, Rostock, Germany
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daniel Woo
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jonathan Rosand
- Center for Genomic Medicine, MGH, Boston, MA, USA,J. Philip Kistler Stroke Research Center, Department of Neurology, MGH, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Guillaume Pare
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Jemma C. Hopewell
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Danish Saleheen
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kari Stefansson
- deCODE genetics/AMGEN Inc., Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Bradford B. Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Steven J. Kittner
- Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD, USA
| | - Sudha Seshadri
- Framingham Heart Study, Framingham, MA, USA,Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, San Antonio, TX, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA,Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hugh S. Markus
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Joanna M. M. Howson
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan,Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Stephanie Debette
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, UK. .,Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France.
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany. .,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany. .,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
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19
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Helgadottir A, Thorleifsson G, Gretarsdottir S, Stefansson OA, Tragante V, Thorolfsdottir RB, Jonsdottir I, Bjornsson T, Steinthorsdottir V, Verweij N, Nielsen JB, Zhou W, Folkersen L, Martinsson A, Heydarpour M, Prakash S, Oskarsson G, Gudbjartsson T, Geirsson A, Olafsson I, Sigurdsson EL, Almgren P, Melander O, Franco-Cereceda A, Hamsten A, Fritsche L, Lin M, Yang B, Hornsby W, Guo D, Brummett CM, Abecasis G, Mathis M, Milewicz D, Body SC, Eriksson P, Willer CJ, Hveem K, Newton-Cheh C, Smith JG, Danielsen R, Thorgeirsson G, Thorsteinsdottir U, Gudbjartsson DF, Holm H, Stefansson K. Genome-wide analysis yields new loci associating with aortic valve stenosis. Nat Commun 2018; 9:987. [PMID: 29511194 PMCID: PMC5840367 DOI: 10.1038/s41467-018-03252-6] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/31/2018] [Indexed: 01/09/2023] Open
Abstract
Aortic valve stenosis (AS) is the most common valvular heart disease, and valve replacement is the only definitive treatment. Here we report a large genome-wide association (GWA) study of 2,457 Icelandic AS cases and 349,342 controls with a follow-up in up to 4,850 cases and 451,731 controls of European ancestry. We identify two new AS loci, on chromosome 1p21 near PALMD (rs7543130; odds ratio (OR) = 1.20, P = 1.2 × 10−22) and on chromosome 2q22 in TEX41 (rs1830321; OR = 1.15, P = 1.8 × 10−13). Rs7543130 also associates with bicuspid aortic valve (BAV) (OR = 1.28, P = 6.6 × 10−10) and aortic root diameter (P = 1.30 × 10−8), and rs1830321 associates with BAV (OR = 1.12, P = 5.3 × 10−3) and coronary artery disease (OR = 1.05, P = 9.3 × 10−5). The results implicate both cardiac developmental abnormalities and atherosclerosis-like processes in the pathogenesis of AS. We show that several pathways are shared by CAD and AS. Causal analysis suggests that the shared risk factors of Lp(a) and non-high-density lipoprotein cholesterol contribute substantially to the frequent co-occurence of these diseases. Aortic valve stenosis (AS) is the most common valvular heart disease. Here the authors identify two new AS loci that also associate with bicuspid aortic valve, aortic root diameter and/or coronary artery disease implicating both developmental abnormalities and atherosclerosis-like processes in AS.
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Affiliation(s)
| | | | | | | | | | | | - Ingileif Jonsdottir
- deCODE genetics/Amgen Inc., Reykjavik, 101, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | | | | | - Niek Verweij
- Department of Cardiology, University of Groningen, University Medical Center Groningen, 9700 RB, Groningen, The Netherlands.,Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA
| | - Jonas B Nielsen
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, 48109, MI, USA
| | - Wei Zhou
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, 48109, MI, USA
| | - Lasse Folkersen
- Cardiovascular Medicine Unit, Department of Medicine, Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, 17176, Sweden.,Department of Bioinformatics, Technical University of Denmark, Copenhagen, 2800, Denmark
| | - Andreas Martinsson
- Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, 22185, Sweden
| | - Mahyar Heydarpour
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA
| | - Siddharth Prakash
- Department of Internal Medicine, Division of Medical Genetics, University of Texas Health Science Center at Houston, Houston, 77030, TX, USA
| | - Gylfi Oskarsson
- Childrens Hospital, Landspitali National University Hospital of Iceland, Reykjavik, 101, Iceland
| | - Tomas Gudbjartsson
- Department of Surgery and Cardiothoracic Surgery, Landspitali National University Hospital, Reykjavik, 101, Iceland
| | - Arnar Geirsson
- Section of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, 06510, CT, USA
| | - Isleifur Olafsson
- Department of Clinical Biochemistry, Landspitali National University Hospital, Reykjavik, 101, Iceland
| | - Emil L Sigurdsson
- Heilsugaeslan Solvangi, Hafnarfjördur, 220, Iceland.,Department of Family Medicine, University of Iceland, Reykjavik, 101, Iceland
| | - Peter Almgren
- Department of Clinical Sciences, Lund University, Malmö, 22185, Sweden.,Department of Internal Medicine, Skåne University Hospital, Malmö, 22185, Sweden
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, 22185, Sweden.,Department of Internal Medicine, Skåne University Hospital, Malmö, 22185, Sweden
| | - Anders Franco-Cereceda
- Cardiothoracic Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, 17176, Sweden
| | - Anders Hamsten
- Cardiovascular Medicine Unit, Department of Medicine, Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, 17176, Sweden
| | - Lars Fritsche
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, 7491, Norway.,K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health, Norwegian University of Science and Technology, Trondheim, 7491, Norway
| | - Maoxuan Lin
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, 48109, MI, USA
| | - Bo Yang
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, 48105, USA.,Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Whitney Hornsby
- Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Dongchuan Guo
- Department of Internal Medicine, Division of Medical Genetics, University of Texas Health Science Center at Houston, Houston, 77030, TX, USA
| | - Chad M Brummett
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, 48105, USA
| | - Gonçalo Abecasis
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Michael Mathis
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, 48105, USA
| | - Dianna Milewicz
- Department of Internal Medicine, Division of Medical Genetics, University of Texas Health Science Center at Houston, Houston, 77030, TX, USA.,Medicine Services, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston, TX, 77030, USA
| | - Simon C Body
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA
| | - Per Eriksson
- Cardiovascular Medicine Unit, Department of Medicine, Karolinska University Hospital Solna, Karolinska Institutet, Stockholm, 17176, Sweden
| | - Cristen J Willer
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, 48109, MI, USA.,Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, 48109, MI, USA.,Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, 48109, USA.,Department of Human Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Kristian Hveem
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, 7491, Norway.,K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health, Norwegian University of Science and Technology, Trondheim, 7491, Norway
| | - Christopher Newton-Cheh
- Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA.,Massachusetts General Hospital, Harvard Medical School, Broad Institute of Harvard and MIT, Boston, MA, 02114, USA.,Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - J Gustav Smith
- Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, 22185, Sweden
| | - Ragnar Danielsen
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland.,Department of Internal Medicine, Division of Cardiology, Landspitali National University Hospital of Iceland, Reykjavik, 101, Iceland
| | - Gudmundur Thorgeirsson
- deCODE genetics/Amgen Inc., Reykjavik, 101, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland.,Department of Internal Medicine, Division of Cardiology, Landspitali National University Hospital of Iceland, Reykjavik, 101, Iceland
| | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen Inc., Reykjavik, 101, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen Inc., Reykjavik, 101, Iceland.,School of Engineering and Natural Sciences, University of Iceland, Reykjavik, 101, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen Inc., Reykjavik, 101, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen Inc., Reykjavik, 101, Iceland. .,Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland.
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20
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Thorolfsdottir RB, Sveinbjornsson G, Sulem P, Helgadottir A, Gretarsdottir S, Benonisdottir S, Magnusdottir A, Davidsson OB, Rajamani S, Roden DM, Darbar D, Pedersen TR, Sabatine MS, Jonsdottir I, Arnar DO, Thorsteinsdottir U, Gudbjartsson DF, Holm H, Stefansson K. A Missense Variant in PLEC Increases Risk of Atrial Fibrillation. J Am Coll Cardiol 2017; 70:2157-2168. [PMID: 29050564 DOI: 10.1016/j.jacc.2017.09.005] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/07/2017] [Accepted: 09/05/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Genome-wide association studies (GWAS) have yielded variants at >30 loci that associate with atrial fibrillation (AF), including rare coding mutations in the sarcomere genes MYH6 and MYL4. OBJECTIVES The aim of this study was to search for novel AF associations and in doing so gain insights into the mechanisms whereby variants affect AF risk, using electrocardiogram (ECG) measurements. METHODS The authors performed a GWAS of 14,255 AF cases and 374,939 controls, using whole-genome sequence data from the Icelandic population, and tested novel signals in 2,002 non-Icelandic cases and 12,324 controls. They then tested the AF variants for effect on cardiac electrical function by using measurements in 289,297 ECGs from 62,974 individuals. RESULTS The authors discovered 2 novel AF variants, the intergenic variant rs72700114, between the genes LINC01142 and METTL11B (risk allele frequency = 8.1%; odds ratio [OR]: 1.26; p = 3.1 × 10-18), and the missense variant p.Gly4098Ser in PLEC (frequency = 1.2%; OR: 1.55; p = 8.0 × 10-10), encoding plectin, a cytoskeletal cross-linking protein that contributes to integrity of cardiac tissue. The authors also confirmed 29 reported variants. p.Gly4098Ser in PLEC significantly affects various ECG measurements in the absence of AF. Other AF variants have diverse effects on the conduction system, ranging from none to extensive. CONCLUSIONS The discovery of a missense variant in PLEC affecting AF combined with recent discoveries of variants in the sarcomere genes MYH6 and MYL4 points to an important role of myocardial structure in the pathogenesis of the disease. The diverse associations between AF variants and ECG measurements suggest fundamentally different categories of mechanisms contributing to the development of AF.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Dan M Roden
- Departments of Medicine, Pharmacology, and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Dawood Darbar
- Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Terje R Pedersen
- Center For Preventive Medicine, Oslo University Hospital and Medical Faculty, University of Oslo, Oslo, Norway
| | - Marc S Sabatine
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ingileif Jonsdottir
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Immunology, Landspitali University Hospital, Reykjavik, Iceland
| | - David O Arnar
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Daniel F Gudbjartsson
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland; School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Hilma Holm
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen, Inc., Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
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21
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Styrkarsdottir U, Helgason H, Sigurdsson A, Norddahl GL, Agustsdottir AB, Reynard LN, Villalvilla A, Halldorsson GH, Jonasdottir A, Magnusdottir A, Oddson A, Sulem G, Zink F, Sveinbjornsson G, Helgason A, Johannsdottir HS, Helgadottir A, Stefansson H, Gretarsdottir S, Rafnar T, Almdahl IS, Brækhus A, Fladby T, Selbæk G, Hosseinpanah F, Azizi F, Koh JM, Tang NLS, Danesphour M, Mayordomo JI, Welt C, Braund PS, Samani NJ, Kiemeney LA, Lohmander LS, Christiansen C, Andreassen OA, consortium A, Magnusson O, Masson G, Kong A, Jonsdottir I, Gudbjartsson D, Sulem P, Jonsson H, Loughlin J, Ingvarsson T, Thorsteinsdottir U, Stefansson K. Erratum: Corrigendum: Whole-genome sequencing identifies rare genotypes in COMP and CHADL associated with high risk of hip osteoarthritis. Nat Genet 2017; 49:1286. [DOI: 10.1038/ng0817-1286b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Traylor M, Malik R, Nalls MA, Cotlarciuc I, Radmanesh F, Thorleifsson G, Hanscombe KB, Langefeld C, Saleheen D, Rost NS, Yet I, Spector TD, Bell JT, Hannon E, Mill J, Chauhan G, Debette S, Bis JC, Longstreth WT, Ikram MA, Launer LJ, Seshadri S, Hamilton-Bruce MA, Jimenez-Conde J, Cole JW, Schmidt R, Słowik A, Lemmens R, Lindgren A, Melander O, Grewal RP, Sacco RL, Rundek T, Rexrode K, Arnett DK, Johnson JA, Benavente OR, Wasssertheil-Smoller S, Lee JM, Pulit SL, Wong Q, Rich SS, de Bakker PIW, McArdle PF, Woo D, Anderson CD, Xu H, Heitsch L, Fornage M, Jern C, Stefansson K, Thorsteinsdottir U, Gretarsdottir S, Lewis CM, Sharma P, Sudlow CLM, Rothwell PM, Boncoraglio GB, Thijs V, Levi C, Meschia JF, Rosand J, Kittner SJ, Mitchell BD, Dichgans M, Worrall BB, Markus HS. Genetic variation at 16q24.2 is associated with small vessel stroke. Ann Neurol 2017; 81:383-394. [PMID: 27997041 PMCID: PMC5366092 DOI: 10.1002/ana.24840] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 12/02/2016] [Accepted: 12/03/2016] [Indexed: 02/03/2023]
Abstract
Objective Genome‐wide association studies (GWAS) have been successful at identifying associations with stroke and stroke subtypes, but have not yet identified any associations solely with small vessel stroke (SVS). SVS comprises one quarter of all ischemic stroke and is a major manifestation of cerebral small vessel disease, the primary cause of vascular cognitive impairment. Studies across neurological traits have shown that younger‐onset cases have an increased genetic burden. We leveraged this increased genetic burden by performing an age‐at‐onset informed GWAS meta‐analysis, including a large younger‐onset SVS population, to identify novel associations with stroke. Methods We used a three‐stage age‐at‐onset informed GWAS to identify novel genetic variants associated with stroke. On identifying a novel locus associated with SVS, we assessed its influence on other small vessel disease phenotypes, as well as on messenger RNA (mRNA) expression of nearby genes, and on DNA methylation of nearby CpG sites in whole blood and in the fetal brain. Results We identified an association with SVS in 4,203 cases and 50,728 controls on chromosome 16q24.2 (odds ratio [OR; 95% confidence interval {CI}] = 1.16 [1.10–1.22]; p = 3.2 × 10−9). The lead single‐nucleotide polymorphism (rs12445022) was also associated with cerebral white matter hyperintensities (OR [95% CI] = 1.10 [1.05–1.16]; p = 5.3 × 10−5; N = 3,670), but not intracerebral hemorrhage (OR [95% CI] = 0.97 [0.84–1.12]; p = 0.71; 1,545 cases, 1,481 controls). rs12445022 is associated with mRNA expression of ZCCHC14 in arterial tissues (p = 9.4 × 10−7) and DNA methylation at probe cg16596957 in whole blood (p = 5.3 × 10−6). Interpretation 16q24.2 is associated with SVS. Associations of the locus with expression of ZCCHC14 and DNA methylation suggest the locus acts through changes to regulatory elements. Ann Neurol 2017;81:383–394
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Affiliation(s)
- Matthew Traylor
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
| | - Rainer Malik
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians University, Munich, Germany
| | - Mike A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD
| | - Ioana Cotlarciuc
- Institute of Cardiovascular Research Royal Holloway University of London (ICR2UL), London, United Kingdom
| | - Farid Radmanesh
- Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital, Boston, MA.,J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Boston, MA.,Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA
| | | | - Ken B Hanscombe
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
| | - Carl Langefeld
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Danish Saleheen
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Natalia S Rost
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Boston, MA
| | - Idil Yet
- Department of Twin Research & Genetic Epidemiology, King's College London, London, United Kingdom
| | - Tim D Spector
- Department of Twin Research & Genetic Epidemiology, King's College London, London, United Kingdom
| | - Jordana T Bell
- Department of Twin Research & Genetic Epidemiology, King's College London, London, United Kingdom
| | - Eilis Hannon
- University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Jonathan Mill
- University of Exeter Medical School, University of Exeter, Exeter, United Kingdom.,Social, Genetic and Developmental Psychiatry Center, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ganesh Chauhan
- Inserm Research Center for Epidemiology and Biostatistics (U897)-Team Neuroepidemiology, Bordeaux, France.,University of Bordeaux, Bordeaux, France
| | - Stephanie Debette
- Inserm Research Center for Epidemiology and Biostatistics (U897)-Team Neuroepidemiology, Bordeaux, France.,University of Bordeaux, Bordeaux, France
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA
| | - W T Longstreth
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA
| | - M Arfan Ikram
- Department of Neurology, Epidemiology and Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD
| | - Sudha Seshadri
- Boston University School of Medicine, Boston, MA.,Framingham Heart Study, Framingham, MA
| | | | | | - Jordi Jimenez-Conde
- Neurovascular Research Group (NEUVAS), Neurology Department, Institut Hospital del Mar d'Investigació Mèdica, Barcelona, Spain
| | - John W Cole
- Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD
| | - Reinhold Schmidt
- Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University, Krakow, Poland
| | - Robin Lemmens
- KU Leuven-University of Leuven, Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), Leuven, Belgium.,VIB, Vesalius Research Center, Laboratory of Neurobiology, Department of Neurology, Leuven, Belgium.,University Hospitals Leuven, Department of Neurology, Leuven, Belgium
| | - Arne Lindgren
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Raji P Grewal
- Neuroscience Institute, Saint Francis Medical Center, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL
| | - Kathryn Rexrode
- Harvard Medical School, Boston, MA, Center for Faculty Development and Diversity, Brigham and Women's Hospital, Boston, MA
| | - Donna K Arnett
- College of Public Health, University of Kentucky, Lexington, KY
| | - Julie A Johnson
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, College of Pharmacy, Gainesville, FL.,Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL
| | - Oscar R Benavente
- Department of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Jin-Moo Lee
- Stroke Center, Department of Neurology, Washington University School of Medicine, Seattle, WA
| | - Sara L Pulit
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Quenna Wong
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, VA
| | - Paul I W de Bakker
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Medical Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Patrick F McArdle
- Department of Medicine, University of Maryland School of Medicine, MD
| | - Daniel Woo
- University of Cincinnati College of Medicine, Cincinnati, OH
| | - Christopher D Anderson
- Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital, Boston, MA.,J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Boston, MA.,Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA.,Program in Medical and Population Genetics, Broad Institute, Boston, MA
| | - Huichun Xu
- Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD
| | - Laura Heitsch
- Division of Emergency Medicine, Washington University School of Medicine, St Louis, MO
| | - Myriam Fornage
- The University of Texas Health Science Center at Houston, Houston, TX
| | - Christina Jern
- Institute of Biomedicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Kari Stefansson
- deCODE genetics/AMGEN, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Unnur Thorsteinsdottir
- deCODE genetics/AMGEN, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Solveig Gretarsdottir
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Cathryn M Lewis
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom.,Social, Genetic and Developmental Psychiatry Center, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Pankaj Sharma
- Institute of Cardiovascular Research Royal Holloway University of London (ICR2UL), London, United Kingdom
| | - Cathie L M Sudlow
- Center for Clinical Brain Sciences & Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Peter M Rothwell
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Giorgio B Boncoraglio
- Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy
| | - Vincent Thijs
- Framingham Heart Study, Framingham, MA.,Department of Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Department of Neurology, Austin Health and Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia
| | - Chris Levi
- John Hunter Hospital, Hunter Medical Research Institute and University of Newcastle, Newcastle, NSW, Australia
| | - James F Meschia
- Department of Neurology, Mayo Clinic Jacksonville, Jacksonville, FL
| | - Jonathan Rosand
- Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital, Boston, MA.,J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Boston, MA.,Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA.,University of Cincinnati College of Medicine, Cincinnati, OH
| | - Steven J Kittner
- Department of Neurology, University of Maryland School of Medicine and Baltimore VAMC, Baltimore, MD
| | - Braxton D Mitchell
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD.,Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians University, Munich, Germany.,Munich Cluster of Systems Neurology, SyNergy, Munich, Germany
| | - Bradford B Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA
| | - Hugh S Markus
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
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Bjornsson E, Helgason H, Halldorsson G, Helgadottir A, Gylfason A, Kehr B, Jonasdottir A, Jonasdottir A, Sigurdsson A, Oddsson A, Thorleifsson G, Magnusson OT, Gretarsdottir S, Zink F, Kristjansson RP, Asgeirsdottir M, Swinkels DW, Kiemeney LA, Eyjolfsson GI, Sigurdardottir O, Masson G, Olafsson I, Thorgeirsson G, Holm H, Thorsteinsdottir U, Gudbjartsson DF, Sulem P, Stefansson K. A rare splice donor mutation in the haptoglobin gene associates with blood lipid levels and coronary artery disease. Hum Mol Genet 2017; 26:2364-2376. [DOI: 10.1093/hmg/ddx123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 03/27/2017] [Indexed: 12/31/2022] Open
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Jones GT, Tromp G, Kuivaniemi H, Gretarsdottir S, Baas AF, Giusti B, Strauss E, Van't Hof FNG, Webb TR, Erdman R, Ritchie MD, Elmore JR, Verma A, Pendergrass S, Kullo IJ, Ye Z, Peissig PL, Gottesman O, Verma SS, Malinowski J, Rasmussen-Torvik LJ, Borthwick KM, Smelser DT, Crosslin DR, de Andrade M, Ryer EJ, McCarty CA, Böttinger EP, Pacheco JA, Crawford DC, Carrell DS, Gerhard GS, Franklin DP, Carey DJ, Phillips VL, Williams MJA, Wei W, Blair R, Hill AA, Vasudevan TM, Lewis DR, Thomson IA, Krysa J, Hill GB, Roake J, Merriman TR, Oszkinis G, Galora S, Saracini C, Abbate R, Pulli R, Pratesi C, Saratzis A, Verissimo AR, Bumpstead S, Badger SA, Clough RE, Cockerill G, Hafez H, Scott DJA, Futers TS, Romaine SPR, Bridge K, Griffin KJ, Bailey MA, Smith A, Thompson MM, van Bockxmeer FM, Matthiasson SE, Thorleifsson G, Thorsteinsdottir U, Blankensteijn JD, Teijink JAW, Wijmenga C, de Graaf J, Kiemeney LA, Lindholt JS, Hughes A, Bradley DT, Stirrups K, Golledge J, Norman PE, Powell JT, Humphries SE, Hamby SE, Goodall AH, Nelson CP, Sakalihasan N, Courtois A, Ferrell RE, Eriksson P, Folkersen L, Franco-Cereceda A, Eicher JD, Johnson AD, Betsholtz C, Ruusalepp A, Franzén O, Schadt EE, Björkegren JLM, Lipovich L, Drolet AM, Verhoeven EL, Zeebregts CJ, Geelkerken RH, van Sambeek MR, van Sterkenburg SM, de Vries JP, Stefansson K, Thompson JR, de Bakker PIW, Deloukas P, Sayers RD, Harrison SC, van Rij AM, Samani NJ, Bown MJ. Meta-Analysis of Genome-Wide Association Studies for Abdominal Aortic Aneurysm Identifies Four New Disease-Specific Risk Loci. Circ Res 2016; 120:341-353. [PMID: 27899403 PMCID: PMC5253231 DOI: 10.1161/circresaha.116.308765] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 10/28/2016] [Accepted: 11/21/2016] [Indexed: 02/06/2023]
Abstract
Supplemental Digital Content is available in the text. Rationale: Abdominal aortic aneurysm (AAA) is a complex disease with both genetic and environmental risk factors. Together, 6 previously identified risk loci only explain a small proportion of the heritability of AAA. Objective: To identify additional AAA risk loci using data from all available genome-wide association studies. Methods and Results: Through a meta-analysis of 6 genome-wide association study data sets and a validation study totaling 10 204 cases and 107 766 controls, we identified 4 new AAA risk loci: 1q32.3 (SMYD2), 13q12.11 (LINC00540), 20q13.12 (near PCIF1/MMP9/ZNF335), and 21q22.2 (ERG). In various database searches, we observed no new associations between the lead AAA single nucleotide polymorphisms and coronary artery disease, blood pressure, lipids, or diabetes mellitus. Network analyses identified ERG, IL6R, and LDLR as modifiers of MMP9, with a direct interaction between ERG and MMP9. Conclusions: The 4 new risk loci for AAA seem to be specific for AAA compared with other cardiovascular diseases and related traits suggesting that traditional cardiovascular risk factor management may only have limited value in preventing the progression of aneurysmal disease.
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Affiliation(s)
| | - Gerard Tromp
- For the author affiliations, please see the Appendix
| | | | | | | | - Betti Giusti
- For the author affiliations, please see the Appendix
| | - Ewa Strauss
- For the author affiliations, please see the Appendix
| | | | - Thomas R Webb
- For the author affiliations, please see the Appendix
| | - Robert Erdman
- For the author affiliations, please see the Appendix
| | | | | | - Anurag Verma
- For the author affiliations, please see the Appendix
| | | | | | - Zi Ye
- For the author affiliations, please see the Appendix
| | | | | | | | | | | | | | | | | | | | - Evan J Ryer
- For the author affiliations, please see the Appendix
| | | | | | | | | | | | | | | | - David J Carey
- For the author affiliations, please see the Appendix
| | | | | | - Wenhua Wei
- For the author affiliations, please see the Appendix
| | - Ross Blair
- For the author affiliations, please see the Appendix
| | - Andrew A Hill
- For the author affiliations, please see the Appendix
| | | | - David R Lewis
- For the author affiliations, please see the Appendix
| | - Ian A Thomson
- For the author affiliations, please see the Appendix
| | - Jo Krysa
- For the author affiliations, please see the Appendix
| | | | - Justin Roake
- For the author affiliations, please see the Appendix
| | | | | | - Silvia Galora
- For the author affiliations, please see the Appendix
| | | | | | | | - Carlo Pratesi
- For the author affiliations, please see the Appendix
| | | | | | | | | | | | | | - Hany Hafez
- For the author affiliations, please see the Appendix
| | | | | | | | | | | | - Marc A Bailey
- For the author affiliations, please see the Appendix
| | - Alberto Smith
- For the author affiliations, please see the Appendix
| | | | | | | | | | | | | | | | | | | | | | | | - Anne Hughes
- For the author affiliations, please see the Appendix
| | | | | | | | - Paul E Norman
- For the author affiliations, please see the Appendix
| | | | | | | | | | | | | | | | | | - Per Eriksson
- For the author affiliations, please see the Appendix
| | | | | | - John D Eicher
- For the author affiliations, please see the Appendix
| | | | | | | | - Oscar Franzén
- For the author affiliations, please see the Appendix
| | - Eric E Schadt
- For the author affiliations, please see the Appendix
| | | | | | - Anne M Drolet
- For the author affiliations, please see the Appendix
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25
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Gudbjartsson DF, Holm H, Sulem P, Masson G, Oddsson A, Magnusson OT, Saemundsdottir J, Helgadottir HT, Helgason H, Johannsdottir H, Gretarsdottir S, Gudjonsson SA, Njølstad I, Løchen ML, Baum L, Ma RCW, Sigfusson G, Kong A, Thorgeirsson G, Sverrisson JT, Thorsteinsdottir U, Stefansson K, Arnar DO. A frameshift deletion in the sarcomere gene MYL4 causes early-onset familial atrial fibrillation. Eur Heart J 2016; 38:27-34. [PMID: 27742809 DOI: 10.1093/eurheartj/ehw379] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 06/04/2016] [Accepted: 08/09/2016] [Indexed: 11/13/2022] Open
Abstract
AIMS Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in man, causing substantial morbidity and mortality with a major worldwide public health impact. It is increasingly recognized as a highly heritable condition. This study aimed to determine genetic risk factors for early-onset AF. METHODS AND RESULTS We sequenced the whole genomes of 8453 Icelanders and imputed genotypes of the 25.5 million sequence variants we discovered into 1799 Icelanders with early-onset AF (diagnosed before 60 years of age) and 337 453 controls. Each sequence variant was tested for association based on multiplicative and recessive inheritance models. We discovered a rare frameshift deletion in the myosin MYL4 gene (c.234delC) that associates with early-onset AF under a recessive mode of inheritance (allelic frequency = 0.58%). We found eight homozygous carriers of the mutation, all of whom had early-onset AF. Six of the homozygotes were diagnosed by the age of 30 and the remaining two in their 50s. Three of the homozygotes had received pacemaker implantations due to sick sinus syndrome, three had suffered an ischemic stroke, and one suffered sudden cardiac death. CONCLUSIONS Through a population approach we found a loss of function mutation in the myosin gene MYL4 that, in the homozygous state, is completely penetrant for early-onset AF. The finding may provide novel mechanistic insight into the pathophysiology of this complex arrhythmia.
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Affiliation(s)
- Daniel F Gudbjartsson
- deCODE genetics, Sturlugata 8, 101 Reykjavik, Iceland .,School of Engineering and Natural Sciences, University of Iceland, Hjardarhaga 4, 107 Reykjavik, Iceland
| | - Hilma Holm
- deCODE genetics, Sturlugata 8, 101 Reykjavik, Iceland.,Department of Medicine, Landspitali- The National University Hospital, Hringbraut, 101 Reykjavik, Iceland
| | - Patrick Sulem
- deCODE genetics, Sturlugata 8, 101 Reykjavik, Iceland
| | - Gisli Masson
- deCODE genetics, Sturlugata 8, 101 Reykjavik, Iceland
| | | | | | | | | | | | | | | | | | - Inger Njølstad
- Institute of Community Medicine, University of Tromsø, Postboks 6050, Langnes, 9037 Tromsø, Norway
| | - Maja-Lisa Løchen
- Institute of Community Medicine, University of Tromsø, Postboks 6050, Langnes, 9037 Tromsø, Norway.,Department of Cardiology, University Hospital of North Norway, Sykehusvegen 38, 9019 Tromsø, Norway
| | - Larry Baum
- School of Pharmacy, Chinese University of Hong Kong, Hong Kong
| | - Ronald C W Ma
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, 30 Ngan Shing Street, Sha Tin 999077 Hong Kong
| | - Gunnlaugur Sigfusson
- Children's Hospital, Landspitali- The National University Hospital, Hringbraut 101 Reykjavik, Iceland
| | - Augustine Kong
- deCODE genetics, Sturlugata 8, 101 Reykjavik, Iceland.,School of Engineering and Natural Sciences, University of Iceland, Hjardarhaga 4, 107 Reykjavik, Iceland
| | - Guðmundur Thorgeirsson
- Department of Medicine, Landspitali- The National University Hospital, Hringbraut, 101 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegi 16, 101 Reykjavik, Iceland
| | - Jon Th Sverrisson
- Department of Internal Medicine, Akureyri Hospital, Eyrarlandsvegur, 600 Akureyri, Iceland
| | - Unnur Thorsteinsdottir
- deCODE genetics, Sturlugata 8, 101 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegi 16, 101 Reykjavik, Iceland
| | - Kari Stefansson
- deCODE genetics, Sturlugata 8, 101 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegi 16, 101 Reykjavik, Iceland
| | - David O Arnar
- deCODE genetics, Sturlugata 8, 101 Reykjavik, Iceland .,Department of Medicine, Landspitali- The National University Hospital, Hringbraut, 101 Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegi 16, 101 Reykjavik, Iceland
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26
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Nioi P, Sigurdsson A, Thorleifsson G, Helgason H, Agustsdottir AB, Norddahl GL, Helgadottir A, Magnusdottir A, Jonasdottir A, Gretarsdottir S, Jonsdottir I, Steinthorsdottir V, Rafnar T, Swinkels DW, Galesloot TE, Grarup N, Jørgensen T, Vestergaard H, Hansen T, Lauritzen T, Linneberg A, Friedrich N, Krarup NT, Fenger M, Abildgaard U, Hansen PR, Galløe AM, Braund PS, Nelson CP, Hall AS, Williams MJA, van Rij AM, Jones GT, Patel RS, Levey AI, Hayek S, Shah SH, Reilly M, Eyjolfsson GI, Sigurdardottir O, Olafsson I, Kiemeney LA, Quyyumi AA, Rader DJ, Kraus WE, Samani NJ, Pedersen O, Thorgeirsson G, Masson G, Holm H, Gudbjartsson D, Sulem P, Thorsteinsdottir U, Stefansson K. Variant ASGR1 Associated with a Reduced Risk of Coronary Artery Disease. N Engl J Med 2016; 374:2131-41. [PMID: 27192541 DOI: 10.1056/nejmoa1508419] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Several sequence variants are known to have effects on serum levels of non-high-density lipoprotein (HDL) cholesterol that alter the risk of coronary artery disease. METHODS We sequenced the genomes of 2636 Icelanders and found variants that we then imputed into the genomes of approximately 398,000 Icelanders. We tested for association between these imputed variants and non-HDL cholesterol levels in 119,146 samples. We then performed replication testing in two populations of European descent. We assessed the effects of an implicated loss-of-function variant on the risk of coronary artery disease in 42,524 case patients and 249,414 controls from five European ancestry populations. An augmented set of genomes was screened for additional loss-of-function variants in a target gene. We evaluated the effect of an implicated variant on protein stability. RESULTS We found a rare noncoding 12-base-pair (bp) deletion (del12) in intron 4 of ASGR1, which encodes a subunit of the asialoglycoprotein receptor, a lectin that plays a role in the homeostasis of circulating glycoproteins. The del12 mutation activates a cryptic splice site, leading to a frameshift mutation and a premature stop codon that renders a truncated protein prone to degradation. Heterozygous carriers of the mutation (1 in 120 persons in our study population) had a lower level of non-HDL cholesterol than noncarriers, a difference of 15.3 mg per deciliter (0.40 mmol per liter) (P=1.0×10(-16)), and a lower risk of coronary artery disease (by 34%; 95% confidence interval, 21 to 45; P=4.0×10(-6)). In a larger set of sequenced samples from Icelanders, we found another loss-of-function ASGR1 variant (p.W158X, carried by 1 in 1850 persons) that was also associated with lower levels of non-HDL cholesterol (P=1.8×10(-3)). CONCLUSIONS ASGR1 haploinsufficiency was associated with reduced levels of non-HDL cholesterol and a reduced risk of coronary artery disease. (Funded by the National Institutes of Health and others.).
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Affiliation(s)
- Paul Nioi
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Asgeir Sigurdsson
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Gudmar Thorleifsson
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Hannes Helgason
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Arna B Agustsdottir
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Gudmundur L Norddahl
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Anna Helgadottir
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Audur Magnusdottir
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Aslaug Jonasdottir
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Solveig Gretarsdottir
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Ingileif Jonsdottir
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Valgerdur Steinthorsdottir
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Thorunn Rafnar
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Dorine W Swinkels
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Tessel E Galesloot
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Niels Grarup
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Torben Jørgensen
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Henrik Vestergaard
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Torben Hansen
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Torsten Lauritzen
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Allan Linneberg
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Nele Friedrich
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Nikolaj T Krarup
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Mogens Fenger
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Ulrik Abildgaard
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Peter R Hansen
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Anders M Galløe
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Peter S Braund
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Christopher P Nelson
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Alistair S Hall
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Michael J A Williams
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Andre M van Rij
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Gregory T Jones
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Riyaz S Patel
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Allan I Levey
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Salim Hayek
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Svati H Shah
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Muredach Reilly
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Gudmundur I Eyjolfsson
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Olof Sigurdardottir
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Isleifur Olafsson
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Lambertus A Kiemeney
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Arshed A Quyyumi
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Daniel J Rader
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - William E Kraus
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Nilesh J Samani
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Oluf Pedersen
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Gudmundur Thorgeirsson
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Gisli Masson
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Hilma Holm
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Daniel Gudbjartsson
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Patrick Sulem
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Unnur Thorsteinsdottir
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
| | - Kari Stefansson
- From deCODE Genetics-Amgen (P.N., A.S., G. Thorleifsson, H. Helgason, A.B.A., G.L.N., A.H., A.M., A.J., S.G., I.J., V.S., T.R., G.M., H. Holm, D.G., P.S., U.T., K.S.), Faculty of Medicine (A.H., I.J., G. Thorgeirsson, U.T., K.S.) and School of Engineering and Natural Sciences (H. Helgason, D.G.), University of Iceland, the Laboratory in Mjodd (G.I.E.), and the Department of Clinical Biochemistry (I.O.) and Division of Cardiology, Department of Internal Medicine (G. Thorgeirsson, H. Holm), Landspitali, National University Hospital of Iceland, Reykjavik, and the Department of Clinical Biochemistry, Akureyri Hospital, Akureyri (O.S.) - all in Iceland; Radboud Institute for Molecular Life Sciences, Department of Laboratory Medicine (D.W.S.), Radboud Institute for Health Sciences (T.E.G., L.A.K.), and the Department of Health Evidence (L.A.K.), Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics (N.G., H.V., T.H., N.T.K., O.P.), and Institute of Public Health, Faculty of Health and Medical Science (T.J., A.L.), University of Copenhagen, and Research Center for Prevention and Health, Capital Region of Denmark (T.J., A.L.), Copenhagen, Faculty of Medicine, University of Aalborg, Aalborg (T.J.), Faculty of Health Sciences, University of Southern Denmark, Odense (T.H.), Department of Public Health, Section of General Practice, University of Aarhus, Aarhus (T.L.), Department of Clinical Experimental Research, Rigshospitalet, Glostrup (A.L.), Department of Clinical Biochemistry, University Hospital of Copenhagen at Hvidovre, Hvidovre (M.F.), Department of Cardiology, Gentofte University Hospital, Hellerup (U.A., P.R.H., A.M.G.), and Department of Cardiology, Roskilde Hospital, Roskilde (A.M.G.) - all in Denmark; Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany (N.F.); Department of Cardiovascular Sciences, Uni
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Thorgeirsson TE, Steinberg S, Reginsson GW, Bjornsdottir G, Rafnar T, Jonsdottir I, Helgadottir A, Gretarsdottir S, Helgadottir H, Jonsson S, Matthiasson SE, Gislason T, Tyrfingsson T, Gudbjartsson T, Isaksson HJ, Hardardottir H, Sigvaldason A, Kiemeney LA, Haugen A, Zienolddiny S, Wolf HJ, Franklin WA, Panadero A, Mayordomo JI, Hall IP, Rönmark E, Lundbäck B, Dirksen A, Ashraf H, Pedersen JH, Masson G, Sulem P, Thorsteinsdottir U, Gudbjartsson DF, Stefansson K. A rare missense mutation in CHRNA4 associates with smoking behavior and its consequences. Mol Psychiatry 2016; 21:594-600. [PMID: 26952864 PMCID: PMC5414061 DOI: 10.1038/mp.2016.13] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 12/17/2015] [Accepted: 01/04/2016] [Indexed: 11/22/2022]
Abstract
Using Icelandic whole-genome sequence data and an imputation approach we searched for rare sequence variants in CHRNA4 and tested them for association with nicotine dependence. We show that carriers of a rare missense variant (allele frequency=0.24%) within CHRNA4, encoding an R336C substitution, have greater risk of nicotine addiction than non-carriers as assessed by the Fagerstrom Test for Nicotine Dependence (P=1.2 × 10(-4)). The variant also confers risk of several serious smoking-related diseases previously shown to be associated with the D398N substitution in CHRNA5. We observed odds ratios (ORs) of 1.7-2.3 for lung cancer (LC; P=4.0 × 10(-4)), chronic obstructive pulmonary disease (COPD; P=9.3 × 10(-4)), peripheral artery disease (PAD; P=0.090) and abdominal aortic aneurysms (AAAs; P=0.12), and the variant associates strongly with the early-onset forms of LC (OR=4.49, P=2.2 × 10(-4)), COPD (OR=3.22, P=2.9 × 10(-4)), PAD (OR=3.47, P=9.2 × 10(-3)) and AAA (OR=6.44, P=6.3 × 10(-3)). Joint analysis of the four smoking-related diseases reveals significant association (P=6.8 × 10(-5)), particularly for early-onset cases (P=2.1 × 10(-7)). Our results are in agreement with functional studies showing that the human α4β2 isoform of the channel containing R336C has less sensitivity for its agonists than the wild-type form following nicotine incubation.
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Affiliation(s)
- T E Thorgeirsson
- deCODE genetics/Amgen, Reykjavik, Iceland,deCODE genetics/Amgen, Sturlugata 8, Reykjavik IS-101, Iceland. E-mail: or
| | | | | | | | - T Rafnar
- deCODE genetics/Amgen, Reykjavik, Iceland
| | - I Jonsdottir
- deCODE genetics/Amgen, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | | | | | - S Jonsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | | | - T Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - T Tyrfingsson
- SAA National Center of Addiction Medicine, Reykjavik, Iceland
| | - T Gudbjartsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland
| | - H J Isaksson
- Department of Pathology, Landspitali University Hospital, Reykjavik, Iceland
| | - H Hardardottir
- Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - A Sigvaldason
- Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - L A Kiemeney
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands,Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Haugen
- Department for the Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
| | - S Zienolddiny
- Department for the Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
| | - H J Wolf
- Community & Behavioral Health, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA
| | - W A Franklin
- Department of Pathology, University of Colorado Denver, Aurora, CO, USA
| | - A Panadero
- Division of Medical Oncology, Hospital Ciudad de Coria, Coria, Spain
| | - J I Mayordomo
- Division of Medical Oncology, University of Colorado School of Medicine, Denver, CO, USA
| | - I P Hall
- Division of Respiratory Medicine, Queens Medical Centre, University of Nottingham, Nottingham, UK
| | - E Rönmark
- The OLIN studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden,Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - B Lundbäck
- The OLIN studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden,Krefting Research Centre, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Dirksen
- Department of Respiratory Medicine, Gentofte Hospital, Copenhagen University, Hellerup, Denmark
| | - H Ashraf
- Department of Respiratory Medicine, Gentofte Hospital, Copenhagen University, Hellerup, Denmark,Centre for Diagnostic Imaging—Thoracic Section, Akershus University Hospital, Loerenskog, Norway
| | - J H Pedersen
- Department of Thoracic Surgery RT, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - G Masson
- deCODE genetics/Amgen, Reykjavik, Iceland
| | - P Sulem
- deCODE genetics/Amgen, Reykjavik, Iceland
| | | | | | - K Stefansson
- deCODE genetics/Amgen, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland,deCODE genetics/Amgen, Sturlugata 8, Reykjavik IS-101, Iceland. E-mail: or
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28
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Gretarsdottir S, Helgason H, Helgadottir A, Sigurdsson A, Thorleifsson G, Magnusdottir A, Oddsson A, Steinthorsdottir V, Rafnar T, de Graaf J, Daneshpour MS, Hedayati M, Azizi F, Grarup N, Jørgensen T, Vestergaard H, Hansen T, Eyjolfsson G, Sigurdardottir O, Olafsson I, Kiemeney LA, Pedersen O, Sulem P, Thorgeirsson G, Gudbjartsson DF, Holm H, Thorsteinsdottir U, Stefansson K. A Splice Region Variant in LDLR Lowers Non-high Density Lipoprotein Cholesterol and Protects against Coronary Artery Disease. PLoS Genet 2015; 11:e1005379. [PMID: 26327206 PMCID: PMC4556698 DOI: 10.1371/journal.pgen.1005379] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/22/2015] [Indexed: 01/08/2023] Open
Abstract
Through high coverage whole-genome sequencing and imputation of the identified variants into a large fraction of the Icelandic population, we found four independent signals in the low density lipoprotein receptor gene (LDLR) that associate with levels of non-high density lipoprotein cholesterol (non-HDL-C) and coronary artery disease (CAD). Two signals are novel with respect to association with non-HDL-C and are represented by non-coding low frequency variants (between 2–4% frequency), the splice region variant rs72658867-A in intron 14 and rs17248748-T in intron one. These two novel associations were replicated in three additional populations. Both variants lower non-HDL-C levels (rs72658867-A, non-HDL-C effect = -0.44 mmol/l, Padj = 1.1 × 10−80 and rs17248748-T, non-HDL-C effect = -0.13 mmol/l, Padj = 1.3 × 10−12) and confer protection against CAD (rs72658867-A, OR = 0.76 and Padj = 2.7 × 10−8 and rs17248748-T, OR = 0.92 and Padj = 0.022). The LDLR splice region variant, rs72658867-A, located at position +5 in intron 14 (NM_000527:c.2140+5G>A), causes retention of intron 14 during transcription and is expected to produce a truncated LDL receptor lacking domains essential for function of the receptor. About half of the transcripts generated from chromosomes carrying rs72658867-A are characterized by this retention of the intron. The same variant also increases LDLR mRNA expression, however, the wild type transcripts do not exceed levels in non-carriers. This demonstrates that sequence variants that disrupt the LDL receptor can lower non-HDL-C and protect against CAD. Cholesterol levels in the bloodstream, in particular elevated low-density lipoprotein cholesterol (LDL-C), are strong risk factors for cardiovascular disease, and LDL-C reduction reduces mortality in people at risk. One of the major determinants of plasma LDL-C levels is the low density lipoprotein receptor (LDLR) that acts as a scavenger for cholesterol rich lipoprotein particles. Mutations that disrupt the function of the LDLR or lead to reduction in the number of LDLR usually result in elevated LDL-C in blood. In the current study, we identified, through whole-genome sequencing and imputation into a large fraction of the Icelandic population, four LDLR gene variants that affect non-HDL-C levels (that includes cholesterol in LDL and other pro-atherogenic lipoproteins) and risk of coronary artery disease (CAD). Two variants are known and two are novel. One of them, a splice region variant in intron 14 (rs72658867-A), affects normal splicing and is predicted to generate a truncated LDLR, lacking domains essential for receptor function. Despite this, rs72658867-A lowers non-HDL-C substantially and protects against CAD in the general population, demonstrating that variants that disrupt the LDLR can result in lower cholesterol levels.
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Affiliation(s)
| | - Hannes Helgason
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Anna Helgadottir
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | | | | | | | | | | | - Jacqueline de Graaf
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Maryam S. Daneshpour
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I. R. Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I. R. Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I. R. Iran
| | - Niels Grarup
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Jørgensen
- Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen, Denmark
- Faculty of Medicine, University of Aalborg, Aalborg, Denmark
- Institute of Public Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Vestergaard
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | | | | | - Isleifur Olafsson
- Department of Clinical Biochemistry, Landspitali, National University Hospital, Reykjavik, Iceland
| | - Lambertus A. Kiemeney
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Oluf Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Gudmundur Thorgeirsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Division of Cardiology, Department of Internal Medicine, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - Daniel F. Gudbjartsson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Hilma Holm
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Division of Cardiology, Department of Internal Medicine, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - Unnur Thorsteinsdottir
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- * E-mail: (UT); (KS)
| | - Kari Stefansson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- * E-mail: (UT); (KS)
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Kilarski LL, Achterberg S, Devan WJ, Traylor M, Malik R, Lindgren A, Pare G, Sharma P, Slowik A, Thijs V, Walters M, Worrall BB, Sale MM, Algra A, Kappelle LJ, Wijmenga C, Norrving B, Sandling JK, Rönnblom L, Goris A, Franke A, Sudlow C, Rothwell PM, Levi C, Holliday EG, Fornage M, Psaty B, Gretarsdottir S, Thorsteinsdottir U, Seshadri S, Mitchell BD, Kittner S, Clarke R, Hopewell JC, Bis JC, Boncoraglio GB, Meschia J, Ikram MA, Hansen BM, Montaner J, Thorleifsson G, Stefanson K, Rosand J, de Bakker PIW, Farrall M, Dichgans M, Markus HS, Bevan S. Meta-analysis in more than 17,900 cases of ischemic stroke reveals a novel association at 12q24.12. Neurology 2014; 83:678-85. [PMID: 25031287 PMCID: PMC4150131 DOI: 10.1212/wnl.0000000000000707] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 03/25/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To perform a genome-wide association study (GWAS) using the Immunochip array in 3,420 cases of ischemic stroke and 6,821 controls, followed by a meta-analysis with data from more than 14,000 additional ischemic stroke cases. METHODS Using the Immunochip, we genotyped 3,420 ischemic stroke cases and 6,821 controls. After imputation we meta-analyzed the results with imputed GWAS data from 3,548 cases and 5,972 controls recruited from the ischemic stroke WTCCC2 study, and with summary statistics from a further 8,480 cases and 56,032 controls in the METASTROKE consortium. A final in silico "look-up" of 2 single nucleotide polymorphisms in 2,522 cases and 1,899 controls was performed. Associations were also examined in 1,088 cases with intracerebral hemorrhage and 1,102 controls. RESULTS In an overall analysis of 17,970 cases of ischemic stroke and 70,764 controls, we identified a novel association on chromosome 12q24 (rs10744777, odds ratio [OR] 1.10 [1.07-1.13], p = 7.12 × 10(-11)) with ischemic stroke. The association was with all ischemic stroke rather than an individual stroke subtype, with similar effect sizes seen in different stroke subtypes. There was no association with intracerebral hemorrhage (OR 1.03 [0.90-1.17], p = 0.695). CONCLUSION Our results show, for the first time, a genetic risk locus associated with ischemic stroke as a whole, rather than in a subtype-specific manner. This finding was not associated with intracerebral hemorrhage.
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Dichgans M, Malik R, König IR, Rosand J, Clarke R, Gretarsdottir S, Thorleifsson G, Mitchell BD, Assimes TL, Levi C, O'Donnell CJ, Fornage M, Thorsteinsdottir U, Psaty BM, Hengstenberg C, Seshadri S, Erdmann J, Bis JC, Peters A, Boncoraglio GB, März W, Meschia JF, Kathiresan S, Ikram MA, McPherson R, Stefansson K, Sudlow C, Reilly MP, Thompson JR, Sharma P, Hopewell JC, Chambers JC, Watkins H, Rothwell PM, Roberts R, Markus HS, Samani NJ, Farrall M, Schunkert H. Shared genetic susceptibility to ischemic stroke and coronary artery disease: a genome-wide analysis of common variants. Stroke 2013; 45:24-36. [PMID: 24262325 DOI: 10.1161/strokeaha.113.002707] [Citation(s) in RCA: 262] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Ischemic stroke (IS) and coronary artery disease (CAD) share several risk factors and each has a substantial heritability. We conducted a genome-wide analysis to evaluate the extent of shared genetic determination of the two diseases. METHODS Genome-wide association data were obtained from the METASTROKE, Coronary Artery Disease Genome-wide Replication and Meta-analysis (CARDIoGRAM), and Coronary Artery Disease (C4D) Genetics consortia. We first analyzed common variants reaching a nominal threshold of significance (P<0.01) for CAD for their association with IS and vice versa. We then examined specific overlap across phenotypes for variants that reached a high threshold of significance. Finally, we conducted a joint meta-analysis on the combined phenotype of IS or CAD. Corresponding analyses were performed restricted to the 2167 individuals with the ischemic large artery stroke (LAS) subtype. RESULTS Common variants associated with CAD at P<0.01 were associated with a significant excess risk for IS and for LAS and vice versa. Among the 42 known genome-wide significant loci for CAD, 3 and 5 loci were significantly associated with IS and LAS, respectively. In the joint meta-analyses, 15 loci passed genome-wide significance (P<5×10(-8)) for the combined phenotype of IS or CAD and 17 loci passed genome-wide significance for LAS or CAD. Because these loci had prior evidence for genome-wide significance for CAD, we specifically analyzed the respective signals for IS and LAS and found evidence for association at chr12q24/SH2B3 (PIS=1.62×10(-7)) and ABO (PIS=2.6×10(-4)), as well as at HDAC9 (PLAS=2.32×10(-12)), 9p21 (PLAS=3.70×10(-6)), RAI1-PEMT-RASD1 (PLAS=2.69×10(-5)), EDNRA (PLAS=7.29×10(-4)), and CYP17A1-CNNM2-NT5C2 (PLAS=4.9×10(-4)). CONCLUSIONS Our results demonstrate substantial overlap in the genetic risk of IS and particularly the LAS subtype with CAD.
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Affiliation(s)
- Martin Dichgans
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany (M.D., R. Malik); Munich Cluster for Systems Neurology (SyNergy), Munich, Germany (M.D.); Institut für Medizinische Biometrie und Statistik (I.R.K.), and Institut für integrative und experimentelle Genomik (J.E.), Universität zu Lübeck, Lübeck, Germany; Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Germany (I.R.K.); Department of Neurology and Center for Human Genetic Research (J.R.), and Cardiology Division (C.J.O.D.), Massachusetts General Hospital, Boston; Harvard Medical School, Boston, MA (J.R.); Program in Medical and Population Genetics (J.R.), and Program in Medical and Population Genetics (S.K.), Broad Institute of Harvard and MIT, Cambridge, MA; Clinical Trial Service Unit and Epidemiological Studies Unit (R.C., J.C.H.), Wellcome Trust Centre for Human Genetics (H.W., M. Farrall), Department of Cardiovascular Medicine (M. Farrall), and Stroke Prevention Research Unit, Nuffield Department of Clinical Neuroscience (P.M.R.), John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom; deCODE Genetics, Reykjavik, Iceland (S.G., G.T., U.T., K.S.); Department of Medicine, University of Maryland School of Medicine, Baltimore (B.D.M.); Department of Medicine, Stanford University School of Medicine, Stanford, CA (T.L.A.); Center for Translational Neuroscience and Mental Health Research, University of Newcastle, New South Wales, Australia (C.L.); Hunter Medical Research Institute, New South Wales, Australia (C.L.); National Heart, Lung and Blood Institute and NHLBI's Framingham Heart Study, MA (C.J.O.D., S.S.); University of Texas Health Science Center at Houston (M. Fornage); Cardiovascular Health Research Unit, Department of Epidemiology (B.M.P.), Department of Medicine (B.M.P.), Department of Health Services (B.M.P.), and Cardiovascular Health Research Unit, Department of Medicine (J.C.B.), University
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Jones GT, Bown MJ, Gretarsdottir S, Romaine SPR, Helgadottir A, Yu G, Tromp G, Norman PE, Jin C, Baas AF, Blankensteijn JD, Kullo IJ, Phillips LV, Williams MJA, Topless R, Merriman TR, Vasudevan TM, Lewis DR, Blair RD, Hill AA, Sayers RD, Powell JT, Deloukas P, Thorleifsson G, Matthiasson SE, Thorsteinsdottir U, Golledge J, Ariëns RA, Johnson A, Sohrabi S, Scott DJ, Carey DJ, Erdman R, Elmore JR, Kuivaniemi H, Samani NJ, Stefansson K, van Rij AM. A sequence variant associated with sortilin-1 (SORT1) on 1p13.3 is independently associated with abdominal aortic aneurysm. Hum Mol Genet 2013; 22:2941-7. [PMID: 23535823 DOI: 10.1093/hmg/ddt141] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abdominal aortic aneurysm (AAA) is a common human disease with a high estimated heritability (0.7); however, only a small number of associated genetic loci have been reported to date. In contrast, over 100 loci have now been reproducibly associated with either blood lipid profile and/or coronary artery disease (CAD) (both risk factors for AAA) in large-scale meta-analyses. This study employed a staged design to investigate whether the loci for these two phenotypes are also associated with AAA. Validated CAD and dyslipidaemia loci underwent screening using the Otago AAA genome-wide association data set. Putative associations underwent staged secondary validation in 10 additional cohorts. A novel association between the SORT1 (1p13.3) locus and AAA was identified. The rs599839 G allele, which has been previously associated with both dyslipidaemia and CAD, reached genome-wide significance in 11 combined independent cohorts (meta-analysis with 7048 AAA cases and 75 976 controls: G allele OR 0.81, 95% CI 0.76-0.85, P = 7.2 × 10(-14)). Modelling for confounding interactions of concurrent dyslipidaemia, heart disease and other risk factors suggested that this marker is an independent predictor of AAA susceptibility. In conclusion, a genetic marker associated with cardiovascular risk factors, and in particular concurrent vascular disease, appeared to independently contribute to susceptibility for AAA. Given the potential genetic overlap between risk factor and disease phenotypes, the use of well-characterized case-control cohorts allowing for modelling of cardiovascular disease risk confounders will be an important component in the future discovery of genetic markers for conditions such as AAA.
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Affiliation(s)
- Gregory T Jones
- Department of Surgery, University of Otago, Dunedin 9054, New Zealand.
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Williams FMK, Carter AM, Hysi PG, Surdulescu G, Hodgkiss D, Soranzo N, Traylor M, Bevan S, Dichgans M, Rothwell PMW, Sudlow C, Farrall M, Silander K, Kaunisto M, Wagner P, Saarela O, Kuulasmaa K, Virtamo J, Salomaa V, Amouyel P, Arveiler D, Ferrieres J, Wiklund PG, Ikram MA, Hofman A, Boncoraglio GB, Parati EA, Helgadottir A, Gretarsdottir S, Thorsteinsdottir U, Thorleifsson G, Stefansson K, Seshadri S, DeStefano A, Gschwendtner A, Psaty B, Longstreth W, Mitchell BD, Cheng YC, Clarke R, Ferrario M, Bis JC, Levi C, Attia J, Holliday EG, Scott RJ, Fornage M, Sharma P, Furie KL, Rosand J, Nalls M, Meschia J, Mosely TH, Evans A, Palotie A, Markus HS, Grant PJ, Spector TD. Ischemic stroke is associated with the ABO locus: the EuroCLOT study. Ann Neurol 2013; 73:16-31. [PMID: 23381943 PMCID: PMC3582024 DOI: 10.1002/ana.23838] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 09/21/2012] [Accepted: 10/29/2012] [Indexed: 11/08/2022]
Abstract
Objective End-stage coagulation and the structure/function of fibrin are implicated in the pathogenesis of ischemic stroke. We explored whether genetic variants associated with end-stage coagulation in healthy REFVIDunteers account for the genetic predisposition to ischemic stroke and examined their influence on stroke subtype. Methods Common genetic variants identified through genome-wide association studies of coagulation factors and fibrin structure/function in healthy twins (n = 2,100, Stage 1) were examined in ischemic stroke (n = 4,200 cases) using 2 independent samples of European ancestry (Stage 2). A third clinical collection having stroke subtyping (total 8,900 cases, 55,000 controls) was used for replication (Stage 3). Results Stage 1 identified 524 single nucleotide polymorphisms (SNPs) from 23 linkage disequilibrium blocks having significant association (p < 5 × 10–8) with 1 or more coagulation/fibrin phenotypes. The most striking associations included SNP rs5985 with factor XIII activity (p = 2.6 × 10–186), rs10665 with FVII (p = 2.4 × 10–47), and rs505922 in the ABO gene with both von Willebrand factor (p = 4.7 × 10–57) and factor VIII (p = 1.2 × 10–36). In Stage 2, the 23 independent SNPs were examined in stroke cases/noncases using MOnica Risk, Genetics, Archiving and Monograph (MORGAM) and Wellcome Trust Case Control Consortium 2 collections. SNP rs505922 was nominally associated with ischemic stroke (odds ratio = 0.94, 95% confidence interval = 0.88–0.99, p = 0.023). Independent replication in Meta-Stroke confirmed the rs505922 association with stroke, beta (standard error, SE) = 0.066 (0.02), p = 0.001, a finding specific to large-vessel and cardioembolic stroke (p = 0.001 and p = < 0.001, respectively) but not seen with small-vessel stroke (p = 0.811). Interpretation ABO gene variants are associated with large-vessel and cardioembolic stroke but not small-vessel disease. This work sheds light on the different pathogenic mechanisms underpinning stroke subtype. Ann Neurol 2013
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Affiliation(s)
- Frances M K Williams
- Department of Twin Research and Genetic Epidemiology, King's College London, United Kingdom.
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Traylor M, Farrall M, Holliday EG, Sudlow C, Hopewell JC, Cheng YC, Fornage M, Ikram MA, Malik R, Bevan S, Thorsteinsdottir U, Nalls MA, Longstreth WT, Wiggins KL, Yadav S, Parati EA, DeStefano AL, Worrall BB, Kittner SJ, Khan MS, Reiner AP, Helgadottir A, Achterberg S, Fernandez-Cadenas I, Abboud S, Schmidt R, Walters M, Chen WM, Ringelstein EB, O'Donnell M, Ho WK, Pera J, Lemmens R, Norrving B, Higgins P, Benn M, Sale M, Kuhlenbäumer G, Doney ASF, Vicente AM, Delavaran H, Algra A, Davies G, Oliveira SA, Palmer CNA, Deary I, Schmidt H, Pandolfo M, Montaner J, Carty C, de Bakker PIW, Kostulas K, Ferro JM, van Zuydam NR, Valdimarsson E, Nordestgaard BG, Lindgren A, Thijs V, Slowik A, Saleheen D, Paré G, Berger K, Thorleifsson G, Hofman A, Mosley TH, Mitchell BD, Furie K, Clarke R, Levi C, Seshadri S, Gschwendtner A, Boncoraglio GB, Sharma P, Bis JC, Gretarsdottir S, Psaty BM, Rothwell PM, Rosand J, Meschia JF, Stefansson K, Dichgans M, Markus HS. Genetic risk factors for ischaemic stroke and its subtypes (the METASTROKE collaboration): a meta-analysis of genome-wide association studies. Lancet Neurol 2012; 11:951-62. [PMID: 23041239 PMCID: PMC3490334 DOI: 10.1016/s1474-4422(12)70234-x] [Citation(s) in RCA: 362] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Various genome-wide association studies (GWAS) have been done in ischaemic stroke, identifying a few loci associated with the disease, but sample sizes have been 3500 cases or less. We established the METASTROKE collaboration with the aim of validating associations from previous GWAS and identifying novel genetic associations through meta-analysis of GWAS datasets for ischaemic stroke and its subtypes. METHODS We meta-analysed data from 15 ischaemic stroke cohorts with a total of 12 389 individuals with ischaemic stroke and 62 004 controls, all of European ancestry. For the associations reaching genome-wide significance in METASTROKE, we did a further analysis, conditioning on the lead single nucleotide polymorphism in every associated region. Replication of novel suggestive signals was done in 13 347 cases and 29 083 controls. FINDINGS We verified previous associations for cardioembolic stroke near PITX2 (p=2·8×10(-16)) and ZFHX3 (p=2·28×10(-8)), and for large-vessel stroke at a 9p21 locus (p=3·32×10(-5)) and HDAC9 (p=2·03×10(-12)). Additionally, we verified that all associations were subtype specific. Conditional analysis in the three regions for which the associations reached genome-wide significance (PITX2, ZFHX3, and HDAC9) indicated that all the signal in each region could be attributed to one risk haplotype. We also identified 12 potentially novel loci at p<5×10(-6). However, we were unable to replicate any of these novel associations in the replication cohort. INTERPRETATION Our results show that, although genetic variants can be detected in patients with ischaemic stroke when compared with controls, all associations we were able to confirm are specific to a stroke subtype. This finding has two implications. First, to maximise success of genetic studies in ischaemic stroke, detailed stroke subtyping is required. Second, different genetic pathophysiological mechanisms seem to be associated with different stroke subtypes. FUNDING Wellcome Trust, UK Medical Research Council (MRC), Australian National and Medical Health Research Council, National Institutes of Health (NIH) including National Heart, Lung and Blood Institute (NHLBI), the National Institute on Aging (NIA), the National Human Genome Research Institute (NHGRI), and the National Institute of Neurological Disorders and Stroke (NINDS).
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Affiliation(s)
- Matthew Traylor
- Stroke and Dementia Research Centre, St George's University of London, London, UK
| | - Martin Farrall
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK,Department of Cardiovascular Medicine, University of Oxford, Oxford, UK
| | - Elizabeth G Holliday
- Centrw for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, and Center for Bioinformatics, Biomarker Discovery and Information-Based Medicine, Hunter Medical Research Institute, NSW, Australia
| | - Cathie Sudlow
- Division of Clinical Neurosciences and Insititute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Jemma C Hopewell
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK
| | - Yu-Ching Cheng
- University of Maryland School of Medicine, Department of Medicine, Baltimore, MD, USA
| | - Myriam Fornage
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands,Department of Neurology and Department of Radiology, Erasmus MC University Medical Center, Rotterdam, Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, Netherlands
| | - Rainer Malik
- Institute for Stroke and Dementia Research, Klinikum der Universitát München, Ludwig-Maximilians-Universität, and Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Steve Bevan
- Stroke and Dementia Research Centre, St George's University of London, London, UK
| | - Unnur Thorsteinsdottir
- deCODE Genetics, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Mike A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD, USA
| | - WT Longstreth
- Department of Neurology, University of Washington, Seattle, WA, USA,Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Kerri L Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Sunaina Yadav
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, UK
| | - Eugenio A Parati
- Department of Cereberovascular Disease, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anita L DeStefano
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Bradford B Worrall
- Department of Neurology, University of Virginia, Charlottesville, VA, USA,Department of Public Health Science, University of Virginia, Charlottesville, VA, USA
| | - Steven J Kittner
- Department of Neurology, Veterans Affairs Medical Center, Baltimore, MA, USA,Department of Neurology, University of Maryland School of Medicine, MA, USA
| | - Muhammad Saleem Khan
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, UK
| | - Alex P Reiner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Anna Helgadottir
- Department of Cardiovascular Medicine, University of Oxford, Oxford, UK,deCODE Genetics, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Sefanja Achterberg
- Department of Neurology and Neurosurgery, Utrecht Stroke Center, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, Netherlands
| | - Israel Fernandez-Cadenas
- Neurovascular Research Laboratory, Neurology and Medicine Departments, Universitat Autònoma de Barcelona and Institute of Research Vall d'Hebrón Hospital, Barcelona, Spain
| | | | - Reinhold Schmidt
- Department of Neurology, Division of Neurogeriatrics, Medical University Graz, Graz, Austria
| | - Matthew Walters
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Wei-Min Chen
- deCODE Genetics, Reykjavik, Iceland,Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | | | | | - Weang Kee Ho
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Joanna Pera
- Department of Neurology, Jagiellonian University, Krakow, Poland
| | - Robin Lemmens
- Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium,Experimental Neurology and Leuven Research Institute for Neurodegenerative Diseases (LIND), University of Leuven (KU Leuven), Leuven, Belgium,Department of Neurology, University Hospital Leuven, Leuven, Belgium
| | - Bo Norrving
- Department of Clinical Sciences Lund, Neurology, Lund University, and Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Peter Higgins
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Marianne Benn
- Department of Clinical Biochemistry and The Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michele Sale
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA,Division of Cardiovascular Medicine, Department of Internal Medicine, University of Virginia, Charlottesville, VA, USA
| | | | - Alexander S F Doney
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Astrid M Vicente
- Departamento Promoção da Saúde e Doenças Crónicas, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal
| | - Hossein Delavaran
- Department of Clinical Sciences Lund, Neurology, Lund University, and Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Ale Algra
- Department of Neurology and Neurosurgery, Utrecht Stroke Center, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, Netherlands,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Gail Davies
- Department of Psychology, and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Sofia A Oliveira
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Colin N A Palmer
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Ian Deary
- Department of Psychology, and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Helena Schmidt
- Institute of Molecular Biology and Biochemistry, Medical University Graz, Graz, Austria
| | | | - Joan Montaner
- Neurovascular Research Laboratory, Neurology and Medicine Departments, Universitat Autònoma de Barcelona and Institute of Research Vall d'Hebrón Hospital, Barcelona, Spain
| | - Cara Carty
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Paul I W de Bakker
- Department of Medical Genetics and Department of Epidemiology, University Medical Centre Utrecht, Utrecht, Netherlands,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA,Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Konstantinos Kostulas
- Department of Neurology, Karolinska Institutet at Karolinska University Hospital, Huddinge, Sweden
| | - Jose M Ferro
- Serviço de Neurologia, Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisbon, Portugal
| | - Natalie R van Zuydam
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | | | - Børge G Nordestgaard
- Department of Clinical Biochemistry and The Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark,The Copenhagen City Heart Study, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Arne Lindgren
- Department of Clinical Sciences Lund, Neurology, Lund University, and Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Vincent Thijs
- Laboratory of Neurobiology, Vesalius Research Center, VIB, Leuven, Belgium,Experimental Neurology and Leuven Research Institute for Neurodegenerative Diseases (LIND), University of Leuven (KU Leuven), Leuven, Belgium,Department of Neurology, University Hospital Leuven, Leuven, Belgium
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University, Krakow, Poland
| | - Danish Saleheen
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK,Centre for Non-Communicable Diseases, Karachi, Pakistan,Department of Medicine, University of Pennsylvania, PA, USA
| | - Guillaume Paré
- Department of Pathology & Molecular Medicine and Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | | | | | - Albert Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands,Netherlands Consortium for Healthy Ageing, Leiden, Netherlands
| | | | - Braxton D Mitchell
- University of Maryland School of Medicine, Department of Medicine, Baltimore, MD, USA
| | - Karen Furie
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK
| | - Christopher Levi
- Centre for Translational Neuroscience and Mental Health Research, University of Newcastle, and Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Sudha Seshadri
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Andreas Gschwendtner
- Institute for Stroke and Dementia Research, Klinikum der Universitát München, Ludwig-Maximilians-Universität, and Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Giorgio B Boncoraglio
- Department of Cereberovascular Disease, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Pankaj Sharma
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, UK
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Bruce M Psaty
- Department of Epidemiology, Department of Medicine, and Department of Health Services, University of Washington, and Group Health Research Institute, Group Health Seattle, WA, USA
| | - Peter M Rothwell
- Stroke Prevention Research Unit, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Jonathan Rosand
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA,University of Mississippi Medical Center, Jackson, MS, USA,Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
| | | | - Kari Stefansson
- deCODE Genetics, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universitát München, Ludwig-Maximilians-Universität, and Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Hugh S Markus
- Stroke and Dementia Research Centre, St George's University of London, London, UK,Correspondence to: Dr Hugh S Markus, Stroke and Dementia Research Centre, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
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34
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Helgadottir A, Gretarsdottir S, Thorleifsson G, Holm H, Patel RS, Gudnason T, Jones GT, van Rij AM, Eapen DJ, Baas AF, Tregouet DA, Morange PE, Emmerich J, Lindblad B, Gottsäter A, Kiemeny LA, Lindholt JS, Sakalihasan N, Ferrell RE, Carey DJ, Elmore JR, Tsao PS, Grarup N, Jørgensen T, Witte DR, Hansen T, Pedersen O, Pola R, Gaetani E, Magnadottir HB, Wijmenga C, Tromp G, Ronkainen A, Ruigrok YM, Blankensteijn JD, Mueller T, Wells PS, Corral J, Soria JM, Souto JC, Peden JF, Jalilzadeh S, Mayosi BM, Keavney B, Strawbridge RJ, Sabater-Lleal M, Gertow K, Baldassarre D, Nyyssönen K, Rauramaa R, Smit AJ, Mannarino E, Giral P, Tremoli E, de Faire U, Humphries SE, Hamsten A, Haraldsdottir V, Olafsson I, Magnusson MK, Samani NJ, Levey AI, Markus HS, Kostulas K, Dichgans M, Berger K, Kuhlenbäumer G, Ringelstein EB, Stoll M, Seedorf U, Rothwell PM, Powell JT, Kuivaniemi H, Onundarson PT, Valdimarsson E, Matthiasson SE, Gudbjartsson DF, Thorgeirsson G, Quyyumi AA, Watkins H, Farrall M, Thorsteinsdottir U, Stefansson K. Apolipoprotein(a) Genetic Sequence Variants Associated With Systemic Atherosclerosis and Coronary Atherosclerotic Burden But Not With Venous Thromboembolism. J Am Coll Cardiol 2012; 60:722-9. [DOI: 10.1016/j.jacc.2012.01.078] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 12/05/2011] [Accepted: 01/03/2012] [Indexed: 11/15/2022]
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35
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Holm H, Gudbjartsson DF, Sulem P, Masson G, Helgadottir HT, Zanon C, Magnusson OT, Helgason A, Saemundsdottir J, Gylfason A, Stefansdottir H, Gretarsdottir S, Matthiasson SE, Thorgeirsson GM, Jonasdottir A, Sigurdsson A, Stefansson H, Werge T, Rafnar T, Kiemeney LA, Parvez B, Muhammad R, Roden DM, Darbar D, Thorleifsson G, Walters GB, Kong A, Thorsteinsdottir U, Arnar DO, Stefansson K. A rare variant in MYH6 is associated with high risk of sick sinus syndrome. Nat Genet 2011; 43:316-20. [PMID: 21378987 PMCID: PMC3066272 DOI: 10.1038/ng.781] [Citation(s) in RCA: 231] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 02/10/2011] [Indexed: 12/16/2022]
Abstract
Through complementary application of SNP genotyping, whole-genome sequencing and imputation in 38,384 Icelanders, we have discovered a previously unidentified sick sinus syndrome susceptibility gene, MYH6, encoding the alpha heavy chain subunit of cardiac myosin. A missense variant in this gene, c.2161C>T, results in the conceptual amino acid substitution p.Arg721Trp, has an allelic frequency of 0.38% in Icelanders and associates with sick sinus syndrome with an odds ratio = 12.53 and P = 1.5 × 10⁻²⁹. We show that the lifetime risk of being diagnosed with sick sinus syndrome is around 6% for non-carriers of c.2161C>T but is approximately 50% for carriers of the c.2161C>T variant.
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Affiliation(s)
- Hilma Holm
- deCODE Genetics, Sturlugata 8, Reykjavik, Iceland.
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36
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Schunkert H, König IR, Kathiresan S, Reilly MP, Assimes TL, Holm H, Preuss M, Stewart AFR, Barbalic M, Gieger C, Absher D, Aherrahrou Z, Allayee H, Altshuler D, Anand SS, Andersen K, Anderson JL, Ardissino D, Ball SG, Balmforth AJ, Barnes TA, Becker DM, Becker LC, Berger K, Bis JC, Boekholdt SM, Boerwinkle E, Braund PS, Brown MJ, Burnett MS, Buysschaert I, Carlquist CJF, Chen L, Cichon S, Codd V, Davies RW, Dedoussis G, Dehghan A, Demissie S, Devaney JM, Do R, Doering A, Eifert S, El Mokhtari NE, Ellis SG, Elosua R, Engert JC, Epstein SE, Faire UD, Fischer M, Folsom AR, Freyer J, Gigante B, Girelli D, Gretarsdottir S, Gudnason V, Gulcher JR, Halperin E, Hammond N, Hazen SL, Hofman A, Horne BD, Illig T, Iribarren C, Jones GT, Jukema J, Kaiser MA, Kaplan LM, Kastelein JJ, Khaw KT, Knowles JW, Kolovou G, Kong A, Laaksonen R, Lambrechts D, Leander K, Lettre G, Li M, Lieb W, Linsel-Nitschke P, Loley C, Lotery AJ, Mannucci PM, Maouche S, Martinelli N, McKeown PP, Meisinger C, Meitinger T, Melander O, Merlini PA, Mooser V, Morgan T, Mühleisen TW, Muhlestein JB, Münzel T, Musunuru K, Nahrstaedt J, Nelson CP, Nöthen MM, Olivieri O, Patel RS, Patterson CC, Peters A, Peyvandi F, Qu L, Quyyumi AA, Rader DJ, Rallidis LS, Rice C, Rosendaal FR, Rubin D, Salomaa V, Sampietro ML, Sandhu MS, Schadt E, Schäfer A, Schillert A, Schreiber S, Schrezenmeir J, Schwartz SM, Siscovick DS, Sivananthan M, Sivapalaratnam S, Smith A, Smith TB, Snoep JD, Soranzo N, Spertus JA, Stark K, Stirrups K, Stoll M, Tang WHW, Tennstedt S, Thorgeirsson G, Thorleifsson G, Tomaszewski M, Uitterlinden AG, van Rij AM, Voight BF, Wareham NJ, Wells GA, Wichmann HE, Wild PS, Willenborg C, Witteman JCM, Wright BJ, Ye S, Zeller T, Ziegler A, Cambien F, Goodall AH, Cupples LA, Quertermous T, März W, Hengstenberg C, Blankenberg S, Ouwehand WH, Hall AS, Deloukas P, Thompson JR, Stefansson K, Roberts R, Thorsteinsdottir U, O’Donnell CJ, McPherson R, Erdmann J, Samani NJ, Samani NJ. Large-scale association analysis identifies 13 new susceptibility loci for coronary artery disease. Nat Genet 2011; 43:333-8. [PMID: 21378990 PMCID: PMC3119261 DOI: 10.1038/ng.784] [Citation(s) in RCA: 1396] [Impact Index Per Article: 107.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 02/10/2011] [Indexed: 02/07/2023]
Abstract
We performed a meta-analysis of 14 genome-wide association studies of coronary artery disease (CAD) comprising 22,233 individuals with CAD (cases) and 64,762 controls of European descent followed by genotyping of top association signals in 56,682 additional individuals. This analysis identified 13 loci newly associated with CAD at P < 5 × 10⁻⁸ and confirmed the association of 10 of 12 previously reported CAD loci. The 13 new loci showed risk allele frequencies ranging from 0.13 to 0.91 and were associated with a 6% to 17% increase in the risk of CAD per allele. Notably, only three of the new loci showed significant association with traditional CAD risk factors and the majority lie in gene regions not previously implicated in the pathogenesis of CAD. Finally, five of the new CAD risk loci appear to have pleiotropic effects, showing strong association with various other human diseases or traits.
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Affiliation(s)
| | - Inke R. König
- Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Lübeck, Germany
| | - Sekar Kathiresan
- Cardiovascular Research Center and Cardiology Division, Massachusetts General Hospital, Boston, MA, USA,Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Muredach P. Reilly
- The Cardiovascular Institute, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | | | | | - Michael Preuss
- Universität zu Lübeck, Medizinische Klinik II, Lübeck, Germany,Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Lübeck, Germany
| | - Alexandre F. R. Stewart
- The John & Jennifer Ruddy Canadian Cardiovascular Genetics Centre, University of Ottawa Heart Institute, Ottawa, Canada
| | - Maja Barbalic
- University of Texas Health Science Center, Human Genetics Center, Houston, TX, USA
| | - Christian Gieger
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Devin Absher
- Hudson Alpha Institute, Huntsville, Alabama, USA
| | | | - Hooman Allayee
- Department of Preventive Medicine University of Southern California Los Angeles, CA USA
| | - David Altshuler
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA,Department of Molecular Biology and Center for Human Genetic Research, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Sonia S. Anand
- Population Health Research Institute, Hamiliton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Karl Andersen
- Department of Medicine, Landspitali University Hospital, 101 Reykjavik, Iceland,University of Iceland, Faculty of Medicine, 101 Reykjavik, Iceland
| | - Jeffrey L. Anderson
- Cardiovascular Department, Intermountain Medical Center; Cardiology Division, University of Utah. Salt Lake City, UT, USA
| | - Diego Ardissino
- Division of Cardiology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Stephen G. Ball
- LIGHT Research Institute, Faculty of Medicine and Health, University of Leeds, Leeds, UK,Division of Cardiovascular and Neuronal Remodelling, Multidisciplinary Cardiovascular Research Centre, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK
| | - Anthony J. Balmforth
- Division of Cardiovascular and Diabetes Research, Multidisciplinary Cardiovascular Research Centre, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, LS2 9JT, UK
| | - Timothy A. Barnes
- Department of Cardiovascular Sciences, University of Leicester, Clinical Sciences Wing, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Diane M. Becker
- The Johns Hopkins University School of Medicine, Division of General Internal Medicine, Baltimore, MD 21287
| | - Lewis C. Becker
- The Johns Hopkins University School of Medicine, Division of General Internal Medicine, Baltimore, MD 21287
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Germany
| | - Joshua C. Bis
- Cardiovascular Health Resarch Unit and Department of Medicine, University of Washington, Seattle, WA USA
| | - S. Matthijs Boekholdt
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands,Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Eric Boerwinkle
- University of Texas Health Science Center, Human Genetics Center, Houston, TX, USA
| | - Peter S. Braund
- Department of Cardiovascular Sciences, University of Leicester, Clinical Sciences Wing, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Morris J. Brown
- Clinical Pharmacology Unit, University of Cambridge, Cambridge, UK
| | - Mary Susan Burnett
- Cardiovascular Research Institute, Medstar Health Research Institute, Washington Hospital Center, Washington, DC 20010, USA
| | - Ian Buysschaert
- Department of Cardiology, University Hospital Gasthuisberg, Leuven, Belgium,Vesalius Research Center, VIB-KULeuven, Leuven, Belgium
| | | | - Li Chen
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada, K1Y 4W7
| | - Sven Cichon
- Institute of Human Genetics, University of Bonn, Bonn, Germany,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany,Institute of Neuroscience and Medicine (INM-1), Research Center Juelich, Juelich, Germany
| | - Veryan Codd
- Department of Cardiovascular Sciences, University of Leicester, Clinical Sciences Wing, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Robert W. Davies
- The Cardiovascular Research Methods, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - George Dedoussis
- Department of Dietetics-Nutrition, Harokopio University, 17671 Athens, Greece
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Member of Netherlands Consortium for Healthy Aging (NCHA) sponsored by Netherlands Genomics Initiative (NGI), Leiden, The Netherlands
| | - Serkalem Demissie
- Department of Biostatistics, Boston University School of Public Health, Boston, MA USA,National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA, USA
| | - Joseph M. Devaney
- Cardiovascular Research Institute, Medstar Health Research Institute, Washington Hospital Center, Washington, DC 20010, USA
| | - Ron Do
- Department of Human Genetics, McGill University, Montreal, Canada
| | - Angela Doering
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | | | | | - Stephen G. Ellis
- Department Cardiovascular Medicine, Cleveland Clinic, Cleveland, USA
| | - Roberto Elosua
- Cardiovascular Epidemiology and Genetics Group, Institut Municipal d’Investigació Mèdica, Barcelona; Ciber Epidemiología y Salud Pública (CIBERSP), Spain
| | - James C. Engert
- Department of Human Genetics, McGill University, Montreal, Canada,Department of Medicine, McGill University, Montreal, Canada
| | - Stephen E. Epstein
- Cardiovascular Research Institute, Medstar Health Research Institute, Washington Hospital Center, Washington, DC 20010, USA
| | - Ulf de Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - Marcus Fischer
- Klinik und Poliklinik für Innere Medizin II, Universität Regensburg, Regensburg, Germany
| | - Aaron R. Folsom
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, School of Public Health (A.R.F.), Minneapolis, Minn.; USA
| | - Jennifer Freyer
- Universität zu Lübeck, Medizinische Klinik II, Lübeck, Germany
| | - Bruna Gigante
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Vilmundur Gudnason
- University of Iceland, Faculty of Medicine, 101 Reykjavik, Iceland,Icelandic Heart Association, Kopavogur Iceland
| | | | - Eran Halperin
- The Blavatnik School of Computer Science , Tel-Aviv University, Tel-Aviv, Israel,Department of Molecular Microbiology and Biotechnology, Tel-Aviv University, Tel-Aviv, Israel,International Computer Science Institute, Berkeley, CA, USA
| | - Naomi Hammond
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | | | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Benjamin D. Horne
- Cardiovascular Department, Intermountain Medical Center; Cardiology Division, University of Utah. Salt Lake City, UT, USA
| | - Thomas Illig
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Carlos Iribarren
- Division of Research, Kaiser Permanente of Northern California, Oakland, California, USA
| | - Gregory T. Jones
- Surgery Department, Dunedin School of Medicine, University of Otago, New Zealand
| | - J.Wouter Jukema
- Department of Cardiology C5-P, Leiden University Medical Center, Leiden, The Netherlands,Durrer Center for Cardiogenetic Research, Amsterdam, The Netherlands
| | - Michael A. Kaiser
- Department of Cardiovascular Sciences, University of Leicester, Clinical Sciences Wing, Glenfield Hospital, Leicester, LE3 9QP, UK
| | | | - John J.P. Kastelein
- Dept. Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge, UK
| | - Joshua W. Knowles
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Genovefa Kolovou
- 1st Cardiology Department, Onassis Cardiac Surgery Center, 356 Sygrou Avenue, 17674 Athens, Greece
| | | | - Reijo Laaksonen
- Science Center, Tampere University Hospital, Tampere, Finland
| | | | - Karin Leander
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Guillaume Lettre
- Montreal Heart Institute, Montréal, Québec, H1T 1C8, Canada,Département de Médecine, Université de Montréal, C.P. 6128, succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada
| | - Mingyao Li
- Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Wolfgang Lieb
- Universität zu Lübeck, Medizinische Klinik II, Lübeck, Germany
| | | | - Christina Loley
- Universität zu Lübeck, Medizinische Klinik II, Lübeck, Germany,Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Lübeck, Germany
| | - Andrew J. Lotery
- Clinical Neurosciences Division, School of Medicine, University of Southampton, Southampton, UK,Southampton Eye Unit, Southampton General Hospital, Southampton, UK
| | - Pier M. Mannucci
- Scientific Direction, IRCCS Fondazione Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Seraya Maouche
- Universität zu Lübeck, Medizinische Klinik II, Lübeck, Germany
| | | | - Pascal P. McKeown
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Science, Belfast, Northern Ireland, UK
| | - Christa Meisinger
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Thomas Meitinger
- Institute of Human Genetics, Helmholtz Zentrum München, Deutsches Forschungszentrum für Umwelt und Gesundheit, Neuherberg, Germany,Institute of Human Genetics, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | - Olle Melander
- Department of Clinical Sciences, Hypertension and Cardiovascular Diseases, Scania University Hospital, Lund University, Malmö, Sweden
| | | | - Vincent Mooser
- Genetics Division and Drug Discovery, GlaxoSmithKline, King of Prussia, Pennsylvania 19406, USA
| | - Thomas Morgan
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville
| | - Thomas W. Mühleisen
- Institute of Human Genetics, University of Bonn, Bonn, Germany,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Joseph B. Muhlestein
- Cardiovascular Department, Intermountain Medical Center; Cardiology Division, University of Utah. Salt Lake City, UT, USA
| | - Thomas Münzel
- 2. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Germany
| | - Kiran Musunuru
- Cardiovascular Research Center and Cardiology Division, Massachusetts General Hospital, Boston, MA, USA,Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Janja Nahrstaedt
- Universität zu Lübeck, Medizinische Klinik II, Lübeck, Germany,Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Lübeck, Germany
| | - Christopher P. Nelson
- Division of Cardiovascular and Diabetes Research, Multidisciplinary Cardiovascular Research Centre, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, LS2 9JT, UK
| | - Markus M. Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | | | - Riyaz S. Patel
- Emory University School of Medicine, Atlanta GA, USA,Cardiff University, Cardiff, Wales, UK CF10 3XQ
| | - Chris C. Patterson
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Science, Belfast, Northern Ireland, UK
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Flora Peyvandi
- A. Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Medicine and Medical Specialties, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano and Luigi Villa Foundation, Milan, Italy
| | - Liming Qu
- Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Daniel J. Rader
- The Cardiovascular Institute, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA,The Institute for Translational Medicine and Therapeutics, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Loukianos S. Rallidis
- Second Department of Cardiology, Attikon Hospital, School of Medicine, University of Athens, Athens, Greece
| | - Catherine Rice
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - Frits R. Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands,Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, The Netherlands,Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Diana Rubin
- Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Veikko Salomaa
- Chronic Disease Epidemiology and Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - M. Lourdes Sampietro
- Department of Human Genetics and Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Manj S. Sandhu
- Manjinder S Sandhu, Genetic Epidemiology Group, Wellcome Trust Sanger Institute, Cambridge, UK,Department of Public Health & Primary Care, Strangeways Research Laboratory, University of Cambridge, UK
| | - Eric Schadt
- Pacific Biosciences, 1505 Adams Drive, Menlo Park, CA 94025,Sage Bionetworks, Palo Alto, CA 94301
| | - Arne Schäfer
- Institut für Klinische Molekularbiologie, Christian-Albrechts Universität, Kiel, Germany
| | - Arne Schillert
- Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Lübeck, Germany
| | - Stefan Schreiber
- Institut für Klinische Molekularbiologie, Christian-Albrechts Universität, Kiel, Germany
| | - Jürgen Schrezenmeir
- Institute of Physiology and Biochemistry of Nutrition, Max Rubner-Institute, Kiel, Germany,Clinical Research Center Kiel, Kiel Innovation and Technology Center, Kiel, Germany
| | - Stephen M. Schwartz
- Cardiovascular Health Resarch Unit and Department of Medicine, University of Washington, Seattle, WA USA
| | - David S. Siscovick
- Cardiovascular Health Resarch Unit and Department of Medicine, University of Washington, Seattle, WA USA
| | | | | | - Albert Smith
- University of Iceland, Faculty of Medicine, 101 Reykjavik, Iceland,Icelandic Heart Association, Kopavogur Iceland
| | - Tamara B. Smith
- Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda MD, USA
| | - Jaapjan D. Snoep
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicole Soranzo
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - John A. Spertus
- Mid America Heart Institute and University of Missouri-Kansas City, Kansas City
| | - Klaus Stark
- Klinik und Poliklinik für Innere Medizin II, Universität Regensburg, Regensburg, Germany
| | - Kathy Stirrups
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - Monika Stoll
- Leibniz-Institute for Arteriosclerosis Research, University of Münster, Münster, Germany
| | - W. H. Wilson Tang
- Department Cardiovascular Medicine, Cleveland Clinic, Cleveland, USA
| | | | - Gudmundur Thorgeirsson
- Department of Medicine, Landspitali University Hospital, 101 Reykjavik, Iceland,University of Iceland, Faculty of Medicine, 101 Reykjavik, Iceland
| | | | - Maciej Tomaszewski
- Department of Cardiovascular Sciences, University of Leicester, Clinical Sciences Wing, Glenfield Hospital, Leicester, LE3 9QP, UK,Leicester National Institute for Health Research Biomedical Research Unit in Cardiovascular Disease, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Andre G. Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Member of Netherlands Consortium for Healthy Aging (NCHA) sponsored by Netherlands Genomics Initiative (NGI), Leiden, The Netherlands,Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Andre M. van Rij
- Surgery Department, Dunedin School of Medicine, University of Otago, New Zealand
| | - Benjamin F. Voight
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Nick J. Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - George A. Wells
- The Cardiovascular Research Methods, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - H.-Erich Wichmann
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany,Klinikum Grosshadern, Munich, Germany,Institute of Medical Information Science, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Germany
| | - Philipp S. Wild
- 2. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Germany
| | - Christina Willenborg
- Universität zu Lübeck, Medizinische Klinik II, Lübeck, Germany,Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Lübeck, Germany
| | - Jaqueline C. M. Witteman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands,Member of Netherlands Consortium for Healthy Aging (NCHA) sponsored by Netherlands Genomics Initiative (NGI), Leiden, The Netherlands
| | - Benjamin J. Wright
- Department of Cardiovascular Surgery, University of Leicester, Leicester, UK
| | - Shu Ye
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Tanja Zeller
- 2. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Germany
| | - Andreas Ziegler
- Institut für Medizinische Biometrie und Statistik, Universität zu Lübeck, Lübeck, Germany
| | - Francois Cambien
- INSERM UMRS 937, Pierre and Marie Curie University, UPMC-Paris 6, Faculté de Médecine Pierre et Marie Curie, Paris, France
| | - Alison H. Goodall
- Department of Cardiovascular Sciences, University of Leicester, Clinical Sciences Wing, Glenfield Hospital, Leicester, LE3 9QP, UK,Leicester National Institute for Health Research Biomedical Research Unit in Cardiovascular Disease, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - L. Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, MA USA,National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA, USA
| | - Thomas Quertermous
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Winfried März
- Synlab Center of Laboratory Diagnostics Heidelberg, Heidelberg, Germany,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria,Institute of Public Health, Social and Preventive Medicine, Medical Faculty Manneim, University of Heidelberg, Germany
| | - Christian Hengstenberg
- Klinik und Poliklinik für Innere Medizin II, Universität Regensburg, Regensburg, Germany
| | - Stefan Blankenberg
- 2. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Johannes-Gutenberg Universität Mainz, Germany
| | - Willem H. Ouwehand
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK,Department of Haematology, University of Cambridge and NHS Blood and Transplant, Cambridge, UK
| | - Alistair S. Hall
- Division of Cardiovascular and Neuronal Remodelling, Multidisciplinary Cardiovascular Research Centre, Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK
| | - Panos Deloukas
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - John R. Thompson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Kari Stefansson
- deCODE Genetics, 101 Reykjavik, Iceland,University of Iceland, Faculty of Medicine, 101 Reykjavik, Iceland
| | - Robert Roberts
- The John & Jennifer Ruddy Canadian Cardiovascular Genetics Centre, University of Ottawa Heart Institute, Ottawa, Canada
| | - Unnur Thorsteinsdottir
- deCODE Genetics, 101 Reykjavik, Iceland,University of Iceland, Faculty of Medicine, 101 Reykjavik, Iceland
| | | | - Ruth McPherson
- The John & Jennifer Ruddy Canadian Cardiovascular Genetics Centre, University of Ottawa Heart Institute, Ottawa, Canada,Atherogenomics Laboratory, University of Ottawa Heart Institute, Ottawa, Canada
| | | | - Nilesh J. Samani
- Department of Cardiovascular Sciences, University of Leicester, Clinical Sciences Wing, Glenfield Hospital, Leicester, LE3 9QP, UK,Leicester National Institute for Health Research Biomedical Research Unit in Cardiovascular Disease, Glenfield Hospital, Leicester, LE3 9QP, UK
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Thorgeirsson TE, Gudbjartsson DF, Surakka I, Vink JM, Amin N, Geller F, Sulem P, Rafnar T, Esko T, Walter S, Gieger C, Rawal R, Mangino M, Prokopenko I, Mägi R, Keskitalo K, Gudjonsdottir IH, Gretarsdottir S, Stefansson H, Thompson JR, Aulchenko YS, Nelis M, Aben KK, den Heijer M, Dirksen A, Ashraf H, Soranzo N, Valdes AM, Steves C, Uitterlinden AG, Hofman A, Tönjes A, Kovacs P, Hottenga JJ, Willemsen G, Vogelzangs N, Döring A, Dahmen N, Nitz B, Pergadia ML, Saez B, De Diego V, Lezcano V, Garcia-Prats MD, Ripatti S, Perola M, Kettunen J, Hartikainen AL, Pouta A, Laitinen J, Isohanni M, Huei-Yi S, Allen M, Krestyaninova M, Hall AS, Jones GT, van Rij AM, Mueller T, Dieplinger B, Haltmayer M, Jonsson S, Matthiasson SE, Oskarsson H, Tyrfingsson T, Kiemeney LA, Mayordomo JI, Lindholt JS, Pedersen JH, Franklin WA, Wolf H, Montgomery GW, Heath AC, Martin NG, Madden PAF, Giegling I, Rujescu D, Järvelin MR, Salomaa V, Stumvoll M, Spector TD, Wichmann HE, Metspalu A, Samani NJ, Penninx BW, Oostra BA, Boomsma DI, Tiemeier H, van Duijn CM, Kaprio J, Gulcher JR, McCarthy MI, Peltonen L, Thorsteinsdottir U, Stefansson K. Sequence variants at CHRNB3-CHRNA6 and CYP2A6 affect smoking behavior. Nat Genet 2010; 42:448-53. [PMID: 20418888 DOI: 10.1038/ng.573] [Citation(s) in RCA: 535] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Accepted: 03/18/2010] [Indexed: 12/14/2022]
Abstract
Smoking is a common risk factor for many diseases. We conducted genome-wide association meta-analyses for the number of cigarettes smoked per day (CPD) in smokers (n = 31,266) and smoking initiation (n = 46,481) using samples from the ENGAGE Consortium. In a second stage, we tested selected SNPs with in silico replication in the Tobacco and Genetics (TAG) and Glaxo Smith Kline (Ox-GSK) consortia cohorts (n = 45,691 smokers) and assessed some of those in a third sample of European ancestry (n = 9,040). Variants in three genomic regions associated with CPD (P < 5 x 10(-8)), including previously identified SNPs at 15q25 represented by rs1051730[A] (effect size = 0.80 CPD, P = 2.4 x 10(-69)), and SNPs at 19q13 and 8p11, represented by rs4105144[C] (effect size = 0.39 CPD, P = 2.2 x 10(-12)) and rs6474412-T (effect size = 0.29 CPD, P = 1.4 x 10(-8)), respectively. Among the genes at the two newly associated loci are genes encoding nicotine-metabolizing enzymes (CYP2A6 and CYP2B6) and nicotinic acetylcholine receptor subunits (CHRNB3 and CHRNA6), all of which have been highlighted in previous studies of smoking and nicotine dependence. Nominal associations with lung cancer were observed at both 8p11 (rs6474412[T], odds ratio (OR) = 1.09, P = 0.04) and 19q13 (rs4105144[C], OR = 1.12, P = 0.0006).
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Affiliation(s)
- Thorgeir E Thorgeirsson
- [1] deCODE Genetics, Reykjavik, Iceland. [2] Center for Biomolecular Science and Engineering, Jack Baskin School of Engineering, University of California, Santa Cruz, California, USA
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Gudbjartsson DF, Holm H, Gretarsdottir S, Thorleifsson G, Walters GB, Thorgeirsson G, Gulcher J, Mathiesen EB, Njølstad I, Nyrnes A, Wilsgaard T, Hald EM, Hveem K, Stoltenberg C, Kucera G, Stubblefield T, Carter S, Roden D, Ng MCY, Baum L, So WY, Wong KS, Chan JCN, Gieger C, Wichmann HE, Gschwendtner A, Dichgans M, Kuhlenbäumer G, Berger K, Ringelstein EB, Bevan S, Markus HS, Kostulas K, Hillert J, Sveinbjörnsdóttir S, Valdimarsson EM, Løchen ML, Ma RCW, Darbar D, Kong A, Arnar DO, Thorsteinsdottir U, Stefansson K. A sequence variant in ZFHX3 on 16q22 associates with atrial fibrillation and ischemic stroke. Nat Genet 2009; 41:876-8. [PMID: 19597491 DOI: 10.1038/ng.417] [Citation(s) in RCA: 354] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Accepted: 06/11/2009] [Indexed: 11/09/2022]
Abstract
We expanded our genome-wide association study on atrial fibrillation (AF) in Iceland, which previously identified risk variants on 4q25, and tested the most significant associations in samples from Iceland, Norway and the United States. A variant in the ZFHX3 gene on chromosome 16q22, rs7193343-T, associated significantly with AF (odds ratio OR = 1.21, P = 1.4 x 10(-10)). This variant also associated with ischemic stroke (OR = 1.11, P = 0.00054) and cardioembolic stroke (OR = 1.22, P = 0.00021) in a combined analysis of five stroke samples.
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Gretarsdottir S, Thorleifsson G, Manolescu A, Styrkarsdottir U, Helgadottir A, Gschwendtner A, Kostulas K, Kuhlenbäumer G, Bevan S, Jonsdottir T, Bjarnason H, Saemundsdottir J, Palsson S, Arnar DO, Holm H, Thorgeirsson G, Valdimarsson EM, Sveinbjörnsdottir S, Gieger C, Berger K, Wichmann HE, Hillert J, Markus H, Gulcher JR, Ringelstein EB, Kong A, Dichgans M, Gudbjartsson DF, Thorsteinsdottir U, Stefansson K. Risk variants for atrial fibrillation on chromosome 4q25 associate with ischemic stroke. Ann Neurol 2008; 64:402-9. [PMID: 18991354 DOI: 10.1002/ana.21480] [Citation(s) in RCA: 215] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kostulas K, Brophy VH, Moraitis K, Manolescu A, Kostulas V, Gretarsdottir S, Cheng S, Hillert J. Genetic profile of ischemic cerebrovascular disease and carotid stenosis. Acta Neurol Scand 2008; 118:146-52. [PMID: 18325076 DOI: 10.1111/j.1600-0404.2008.00995.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Carotid artery stenosis (CS) is a major risk factor for ischemic cerebrovascular disease (ICVD) and is therefore of interest in genetic investigating. Here we report the distribution of 100 polymorphisms in 47 suspected susceptibility genes for ICVD and its risk factors. MATERIALS AND METHODS Previously published markers in suspected susceptibility genes were genotyped in ICVD patients and controls (928/602). Genotyping was performed using multiplex polymerase chain reaction (PCR) and linear immobilized probe array assays. ICVD cases were subtyped according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) or subdivided into CS and non-CS patients by ultrasonography in a separate analysis. RESULTS Three polymorphisms located in the lipoprotein lipase (LPL), angiotensinogen (AGT) and guanine nucleotide-binding protein beta-3 (GNB3) genes were significantly associated with ICVD after correction for age and gender. The strongest association was found for the protective LPL Ser447Term polymorphism. All the significant markers showed varying frequencies in different subphenotypes of ICVD. Factor VII, apolipoprotein E and two renin polymorphisms were differentially frequent in patients with evidence of CS compared with non-CS patients. CONCLUSIONS We have found that some previously described susceptibility polymorphisms are weakly associated with ICVD and that subdivision of patients into CS and non-CS groups may help to identify new candidate polymorphisms.
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Affiliation(s)
- K Kostulas
- Department of Neurology, Neuro-Angiological Research Center, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden.
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Gudbjartsson DF, Sulem P, Stacey SN, Goldstein AM, Rafnar T, Sigurgeirsson B, Benediktsdottir KR, Thorisdottir K, Ragnarsson R, Sveinsdottir SG, Magnusson V, Lindblom A, Kostulas K, Botella-Estrada R, Soriano V, Juberías P, Grasa M, Saez B, Andres R, Scherer D, Rudnai P, Gurzau E, Koppova K, Kiemeney LA, Jakobsdottir M, Steinberg S, Helgason A, Gretarsdottir S, Tucker MA, Mayordomo JI, Nagore E, Kumar R, Hansson J, Olafsson JH, Gulcher J, Kong A, Thorsteinsdottir U, Stefansson K. Erratum: Corrigendum: ASIP and TYR pigmentation variants associate with cutaneous melanoma and basal cell carcinoma. Nat Genet 2008. [DOI: 10.1038/ng0808-1029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Palsdottir A, Helgason A, Palsson S, Bjornsson HT, Bragason BT, Gretarsdottir S, Thorsteinsdottir U, Olafsson E, Stefansson K. A drastic reduction in the life span of cystatin C L68Q carriers due to life-style changes during the last two centuries. PLoS Genet 2008; 4:e1000099. [PMID: 18566660 PMCID: PMC2409978 DOI: 10.1371/journal.pgen.1000099] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2008] [Accepted: 05/15/2008] [Indexed: 11/18/2022] Open
Abstract
Hereditary cystatin C amyloid angiopathy (HCCAA) is an autosomal dominant disease with high penetrance, manifest by brain hemorrhages in young normotensive adults. In Iceland, this condition is caused by the L68Q mutation in the cystatin C gene, with contemporary carriers reaching an average age of only 30 years. Here, we report, based both on linkage disequilibrium and genealogical evidence, that all known copies of this mutation derive from a common ancestor born roughly 18 generations ago. Intriguingly, the genealogies reveal that obligate L68Q carriers born 1825 to 1900 experienced a drastic reduction in life span, from 65 years to the present-day average. At the same time, a parent-of-origin effect emerged, whereby maternal inheritance of the mutation was associated with a 9 year reduction in life span relative to paternal inheritance. As these trends can be observed in several different extended families, many generations after the mutational event, it seems likely that some environmental factor is responsible, perhaps linked to radical changes in the life-style of Icelanders during this period. A mutation with such radically different phenotypic effects in reaction to normal variation in human life-style not only opens the possibility of preventive strategies for HCCAA, but it may also provide novel insights into the complex relationship between genotype and environment in human disease.
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Affiliation(s)
- Astridur Palsdottir
- Institute for Experimental Pathology, University of Iceland, Keldur, Reykjavik, Iceland.
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Styrkarsdottir U, Halldorsson BV, Gretarsdottir S, Gudbjartsson DF, Walters GB, Ingvarsson T, Jonsdottir T, Saemundsdottir J, Center JR, Nguyen TV, Bagger Y, Gulcher JR, Eisman JA, Christiansen C, Sigurdsson G, Kong A, Thorsteinsdottir U, Stefansson K. Multiple genetic loci for bone mineral density and fractures. N Engl J Med 2008; 358:2355-65. [PMID: 18445777 DOI: 10.1056/nejmoa0801197] [Citation(s) in RCA: 459] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Bone mineral density influences the risk of osteoporosis later in life and is useful in the evaluation of the risk of fracture. We aimed to identify sequence variants associated with bone mineral density and fracture. METHODS We performed a quantitative trait analysis of data from 5861 Icelandic subjects (the discovery set), testing for an association between 301,019 single-nucleotide polymorphisms (SNPs) and bone mineral density of the hip and lumbar spine. We then tested for an association between 74 SNPs (most of which were implicated in the discovery set) at 32 loci in replication sets of Icelandic, Danish, and Australian subjects (4165, 2269, and 1491 subjects, respectively). RESULTS Sequence variants in five genomic regions were significantly associated with bone mineral density in the discovery set and were confirmed in the replication sets (combined P values, 1.2x10(-7) to 2.0x10(-21)). Three regions are close to or within genes previously shown to be important to the biologic characteristics of bone: the receptor activator of nuclear factor-kappaB ligand gene (RANKL) (chromosomal location, 13q14), the osteoprotegerin gene (OPG) (8q24), and the estrogen receptor 1 gene (ESR1) (6q25). The two other regions are close to the zinc finger and BTB domain containing 40 gene (ZBTB40) (1p36) and the major histocompatibility complex region (6p21). The 1p36, 8q24, and 6p21 loci were also associated with osteoporotic fractures, as were loci at 18q21, close to the receptor activator of the nuclear factor-kappaB gene (RANK), and loci at 2p16 and 11p11. CONCLUSIONS We have discovered common sequence variants that are consistently associated with bone mineral density and with low-trauma fractures in three populations of European descent. Although these variants alone are not clinically useful in the prediction of risk to the individual person, they provide insight into the biochemical pathways underlying osteoporosis.
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Kostulas K, Gretarsdottir S, Kostulas V, Manolescu A, Helgadottir A, Thorleifsson G, Gudmundsson LJ, Thorsteinsdottir U, Gulcher JR, Stefansson K, Hillert J. PDE4D and ALOX5AP genetic variants and risk for Ischemic Cerebrovascular Disease in Sweden. J Neurol Sci 2007; 263:113-7. [PMID: 17655870 DOI: 10.1016/j.jns.2007.06.042] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2006] [Revised: 06/06/2007] [Accepted: 06/20/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Genetic variants in Phosphodiesterase 4D (PDE4D) and 5-lipoxygenase activating protein (ALOX5AP) have been shown to confer risk of Ischemic Cerebrovascular Disease (ICVD) in Iceland. We investigated whether these variants associate with ICVD in Sweden. METHODS Previously published PDE4D and ALOX5AP gene variants were genotyped for cases (685) and controls (751). In PDE4D this consisted of SNP41, SNP45 and microsatellite AC008818-1 and in ALOX5AP four SNPs that define the HapA haplotype. RESULTS The PDE4D SNPs, showed a non-significant risk in the ICVD group which increased for the Large Artery Atherosclerosis subtype (SNP45: RR=1.43, P=0.063, SNP41: RR=1.57, P=0.018). The SNP haplotype GA (SNP45, SNP41) showed an increased risk for LAA (RR=1.58, P=0.016) and the combined LAA and Cardioembolism (CE) (RR=1.34, P=0.031) subgroups. As the SNPs are in strong LD, this haplotype corresponds to the complement of the protective haplotype in the Icelandic study. No allele of the microsatellite marker, showed association to stroke or any subtype and nor did the Icelandic PDE4D at-risk haplotype (GA0). We did not confirm the association between ALOX5AP HapA haplotype and ICVD, but a non-significant risk was observed in the LAA subtype. CONCLUSION Our PDE4D findings although non-significant considering the number of markers and phenotypes tested, are consistent with the association observed in the original study, with a trend observed in the whole ICVD group, which was strengthened in the stroke subtype LAA and the combined group of LAA and CE stroke. This supports the notion that PDE4D contributes to the risk of developing stroke.
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Affiliation(s)
- Konstantinos Kostulas
- Department of Neurology, Neuro-angiological Research Center, Karolinska Institutet, Karolinska University Hospital Huddinge, S-141 86 Huddinge, Sweden.
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Gudbjartsson DF, Arnar DO, Helgadottir A, Gretarsdottir S, Holm H, Sigurdsson A, Jonasdottir A, Baker A, Thorleifsson G, Kristjansson K, Palsson A, Blondal T, Sulem P, Backman VM, Hardarson GA, Palsdottir E, Helgason A, Sigurjonsdottir R, Sverrisson JT, Kostulas K, Ng MCY, Baum L, So WY, Wong KS, Chan JCN, Furie KL, Greenberg SM, Sale M, Kelly P, MacRae CA, Smith EE, Rosand J, Hillert J, Ma RCW, Ellinor PT, Thorgeirsson G, Gulcher JR, Kong A, Thorsteinsdottir U, Stefansson K. Variants conferring risk of atrial fibrillation on chromosome 4q25. Nature 2007; 448:353-7. [PMID: 17603472 DOI: 10.1038/nature06007] [Citation(s) in RCA: 661] [Impact Index Per Article: 38.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2007] [Accepted: 06/11/2007] [Indexed: 11/09/2022]
Abstract
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in humans and is characterized by chaotic electrical activity of the atria. It affects one in ten individuals over the age of 80 years, causes significant morbidity and is an independent predictor of mortality. Recent studies have provided evidence of a genetic contribution to AF. Mutations in potassium-channel genes have been associated with familial AF but account for only a small fraction of all cases of AF. We have performed a genome-wide association scan, followed by replication studies in three populations of European descent and a Chinese population from Hong Kong and find a strong association between two sequence variants on chromosome 4q25 and AF. Here we show that about 35% of individuals of European descent have at least one of the variants and that the risk of AF increases by 1.72 and 1.39 per copy. The association with the stronger variant is replicated in the Chinese population, where it is carried by 75% of individuals and the risk of AF is increased by 1.42 per copy. A stronger association was observed in individuals with typical atrial flutter. Both variants are adjacent to PITX2, which is known to have a critical function in left-right asymmetry of the heart.
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Helgadottir A, Thorleifsson G, Manolescu A, Gretarsdottir S, Blondal T, Jonasdottir A, Jonasdottir A, Sigurdsson A, Baker A, Palsson A, Masson G, Gudbjartsson DF, Magnusson KP, Andersen K, Levey AI, Backman VM, Matthiasdottir S, Jonsdottir T, Palsson S, Einarsdottir H, Gunnarsdottir S, Gylfason A, Vaccarino V, Hooper WC, Reilly MP, Granger CB, Austin H, Rader DJ, Shah SH, Quyyumi AA, Gulcher JR, Thorgeirsson G, Thorsteinsdottir U, Kong A, Stefansson K. A common variant on chromosome 9p21 affects the risk of myocardial infarction. Science 2007; 316:1491-3. [PMID: 17478679 DOI: 10.1126/science.1142842] [Citation(s) in RCA: 1204] [Impact Index Per Article: 70.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The global endemic of cardiovascular diseases calls for improved risk assessment and treatment. Here, we describe an association between myocardial infarction (MI) and a common sequence variant on chromosome 9p21. This study included a total of 4587 cases and 12,767 controls. The identified variant, adjacent to the tumor suppressor genes CDKN2A and CDKN2B, was associated with the disease with high significance. Approximately 21% of individuals in the population are homozygous for this variant, and their estimated risk of suffering myocardial infarction is 1.64 times as great as that of noncarriers. The corresponding risk is 2.02 times as great for early-onset cases. The population attributable risk is 21% for MI in general and 31% for early-onset cases.
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Steinthorsdottir V, Thorleifsson G, Reynisdottir I, Benediktsson R, Jonsdottir T, Walters GB, Styrkarsdottir U, Gretarsdottir S, Emilsson V, Ghosh S, Baker A, Snorradottir S, Bjarnason H, Ng MCY, Hansen T, Bagger Y, Wilensky RL, Reilly MP, Adeyemo A, Chen Y, Zhou J, Gudnason V, Chen G, Huang H, Lashley K, Doumatey A, So WY, Ma RCY, Andersen G, Borch-Johnsen K, Jorgensen T, van Vliet-Ostaptchouk JV, Hofker MH, Wijmenga C, Christiansen C, Rader DJ, Rotimi C, Gurney M, Chan JCN, Pedersen O, Sigurdsson G, Gulcher JR, Thorsteinsdottir U, Kong A, Stefansson K. A variant in CDKAL1 influences insulin response and risk of type 2 diabetes. Nat Genet 2007; 39:770-5. [PMID: 17460697 DOI: 10.1038/ng2043] [Citation(s) in RCA: 753] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2007] [Accepted: 04/17/2007] [Indexed: 12/21/2022]
Abstract
We conducted a genome-wide association study for type 2 diabetes (T2D) in Icelandic cases and controls, and we found that a previously described variant in the transcription factor 7-like 2 gene (TCF7L2) gene conferred the most significant risk. In addition to confirming two recently identified risk variants, we identified a variant in the CDKAL1 gene that was associated with T2D in individuals of European ancestry (allele-specific odds ratio (OR) = 1.20 (95% confidence interval, 1.13-1.27), P = 7.7 x 10(-9)) and individuals from Hong Kong of Han Chinese ancestry (OR = 1.25 (1.11-1.40), P = 0.00018). The genotype OR of this variant suggested that the effect was substantially stronger in homozygous carriers than in heterozygous carriers. The ORs for homozygotes were 1.50 (1.31-1.72) and 1.55 (1.23-1.95) in the European and Hong Kong groups, respectively. The insulin response for homozygotes was approximately 20% lower than for heterozygotes or noncarriers, suggesting that this variant confers risk of T2D through reduced insulin secretion.
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Gulcher JR, Kong A, Gretarsdottir S, Thorleifsson G, Stefansson K. Reply to “Many hypotheses but no replication for the association between PDE4D and stroke”. Nat Genet 2006. [DOI: 10.1038/ng1006-1092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Helgadottir A, Manolescu A, Helgason A, Thorleifsson G, Thorsteinsdottir U, Gudbjartsson DF, Gretarsdottir S, Magnusson KP, Gudmundsson G, Hicks A, Jonsson T, Grant SFA, Sainz J, O'Brien SJ, Sveinbjornsdottir S, Valdimarsson EM, Matthiasson SE, Levey AI, Abramson JL, Reilly MP, Vaccarino V, Wolfe ML, Gudnason V, Quyyumi AA, Topol EJ, Rader DJ, Thorgeirsson G, Gulcher JR, Hakonarson H, Kong A, Stefansson K. A variant of the gene encoding leukotriene A4 hydrolase confers ethnicity-specific risk of myocardial infarction. Nat Genet 2005; 38:68-74. [PMID: 16282974 DOI: 10.1038/ng1692] [Citation(s) in RCA: 294] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2005] [Accepted: 10/05/2005] [Indexed: 11/09/2022]
Abstract
Variants of the gene ALOX5AP (also known as FLAP) encoding arachidonate 5-lipoxygenase activating protein are known to be associated with risk of myocardial infarction. Here we show that a haplotype (HapK) spanning the LTA4H gene encoding leukotriene A4 hydrolase, a protein in the same biochemical pathway as ALOX5AP, confers modest risk of myocardial infarction in an Icelandic cohort. Measurements of leukotriene B4 (LTB4) production suggest that this risk is mediated through upregulation of the leukotriene pathway. Three cohorts from the United States also show that HapK confers a modest relative risk (1.16) in European Americans, but it confers a threefold larger risk in African Americans. About 27% of the European American controls carried at least one copy of HapK, as compared with only 6% of African American controls. Our analyses indicate that HapK is very rare in Africa and that its occurrence in African Americans is due to European admixture. Interactions with other genetic or environmental risk factors that are more common in African Americans are likely to account for the greater relative risk conferred by HapK in this group.
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